Compounds for treatment of complement mediated disorders

ABSTRACT

Compounds, methods of use, and processes for making inhibitors of complement factor D comprising Formula I, or a pharmaceutically acceptable salt or composition thereof are provided. The inhibitors described herein target factor D and inhibit or regulate the complement cascade. The inhibitors of factor D described herein are capable of reducing the excessive activation of complement.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of International Application No. PCT/US15/17609, filed Feb. 25, 2015, which claims the benefit of provisional U.S. Application No. 61/944,189 filed Feb. 25, 2014, provisional U.S. Application No. 62/022,916 filed Jul. 10, 2014, and provisional U.S. Application 62/046,783 filed Sep. 5, 2014. The entirety of each of these applications is hereby incorporated by reference for all purposes.

BACKGROUND

The complement system is a part of the innate immune system which does not adapt to changes over the course of the host's life, but is recruited and used by the adaptive immune system. For example, it assists, or complements, the ability of antibodies and phagocytic cells to clear pathogens. This sophisticated regulatory pathway allows rapid reaction to pathogenic organisms while protecting host cells from destruction. Over thirty proteins and protein fragments make up the complement system. These proteins act through opsonization (enhancing phaogytosis of antigens), chemotaxis (attracting macrophages and neutrophils), cell lysis (rupturing membranes of foreign cells) and agglutination (clustering and binding of pathogens together).

The complement system has three pathways: classical, alternative and lectin. Complement factor D plays an early and central role in activation of the alternative pathway of the complement cascade. Activation of the alternative complement pathway is initiated by spontaneous hydrolysis of a thioester bond within C3 to produce C3(H₂O), which associates with factor B to form the C3(H₂O)B complex. Complement factor D acts to cleave factor B within the C3(H₂O)B complex to form Ba and Bb. The Bb fragment remains associated with C3(H₂O) to form the alternative pathway C3 convertase C3(H₂O)Bb. Additionally, C3b generated by any of the C3 convertases also associates with factor B to form C3bB, which factor D cleaves to generate the later stage alternative pathway C3 convertase C3bBb. This latter form of the alternative pathway C3 convertase may provide important downstream amplification within all three of the defined complement pathways, leading ultimately to the recruitment and assembly of additional factors in the complement cascade pathway, including the cleavage of C5 to C5a and C5b. C5b acts in the assembly of factors C6, C7, C8, and C9 into the membrane attack complex, which can destroy pathogenic cells by lysing the cell.

The dysfunction of or excessive activation of complement has been linked to certain autoimmune, inflammatory, and neurodegenerative diseases, as well as ischemia-reperfusion injury and cancer. For example, activation of the alternative pathway of the complement cascade contributes to the production of C3a and C5a, both potent anaphylatoxins, which also have roles in a number of inflammatory disorders. Therefore, in some instances, it is desirable to decrease the response of the complement pathway, including the alternative complement pathway. Some examples of disorders mediated by the complement pathway include age-related macular degeneration (AMD), paroxysmal nocturnal hemoglobinuria (PNH), multiple sclerosis, and rheumatoid arthritis.

Age-related macular degeneration (AMD) is a leading cause of vision loss in industrialized countries. Based on a number of genetic studies, there is evidence of the link between the complement cascade and macular degeneration. Individuals with mutations in the gene encoding complement factor H have a fivefold increased risk of macular degeneration and individuals with mutations in other complement factor genes also have an increased risk of AMD. Individuals with mutant factor H also have increased levels of C-reactive protein, a marker of inflammation. Without adequate functioning factor H, the alternative pathway of the complement cascade is overly activated leading to cellular damage. Inhibition of the alternative pathway is thus desired.

Paroxysmal nocturnal hemoglobinuria (PNH) is a non-malignant, hematological disorder characterized by the expansion of hematopoietic stem cells and progeny mature blood cells which are deficient in some surface proteins. PNH erythrocytes are not capable of modulating their surface complement activation, which leads to the typical hallmark of PNH—the chronic activation of complement mediated intravascular anemia. Currently, only one product, the anti-C5 monoclonal antibody eculizumab, has been approved in the U.S. for treatment of PNH. However, many of the patients treated with eculizumab remain anemic, and many patients continue to require blood transfusions. In addition, treatment with eculizumab requires life-long intravenous injections. Thus, there is an unmet need to develop novel inhibitors of the complement pathway.

Factor D is an attractive target for inhibition or regulation of the complement cascade due to its early and essential role in the alternative complement pathway, and its potential role in signal amplification within the classical and lectin complement pathways. Inhibition of factor D effectively interrupts the pathway and attenuates the formation of the membrane attack complex.

While initial attempts have been made to develop inhibitors of factor D, there are currently no small molecule factor D inhibitors in clinical trials. Examples of factor D inhibitors or prolyl compounds are described in the following disclosures.

Biocryst Pharmaceuticals U.S. Pat. No. 6,653,340 titled “Compounds useful in the complement, coagulat and kallikrein pathways and method for their preparation” describes fused bicyclic ring compounds that are potent inhibitors of factor D. Development of the factor D inhibitor BCX1470 was discontinued due to lack of specificity and short half-life of the compound.

Novartis PCT patent publication WO2012/093101 titled “Indole compounds or analogues thereof useful for the treatment of age-related macular degeneration” describes certain factor D inhibitors.

Novartis PCT patent publications WO2014/002057 titled “Pyrrolidine derivatives and their use as complement pathway modulators” and WO2014/009833 titled “Complement pathway modulators and uses thereof” describe additional factor D inhibitors with heterocyclic substituents. Additional factor D inhibitors are described in Novartis PCT patent publications WO2014/002051, WO2014/002052, WO2014/002053, WO2014/002054, WO2014/002058, WO2014/002059, and WO2014/005150.

Bristol-Myers Squibb PCT patent publication WO2004/045518 titled “Open chain prolyl urea-related modulators of androgen receptor function” describes open chain prolyl urea and thiourea related compounds for the treatment of androgen receptor-associated conditions, such as age-related diseases, for example, sarcopenia.

Japan Tobacco Inc. PCT patent publication WO1999/048492 titled “Amide derivatives and nociceptin antagonists” describes compounds with a proline-like core and aromatic substituents connected to the proline core through amide linkages useful for the treatment of pain.

Ferring B.V. and Yamanouchi Pharmaceutical Co. lTD. PCT patent publication WO1993/020099 titled “CCK and/or gastrin receptor ligands” describes compounds with a proline-like core and heterocyclic substituents connected to the proline core through amide linkages for the treatment of, for example, gastric disorders or pain.

Alexion Pharmaceuticals PCT patent publication WO1995/029697 titled “Methods and compositions for the treatment of glomerulonephritis and other inflammatory diseases” discloses antibodies directed to C5 of the complement pathway for the treatment of glomerulonephritis and inflammatory conditions involving pathologic activation of the complement system. Alexion Pharmaceutical's anti-C5 antibody eculizumab (Soliris®) is currently the only complement-specific antibody on the market, and is the first and only approved treatment for paroxysmal nocturnal hemoglobinuria (PNH).

Compounds which mediate the complement pathway, and for example, act as factor D inhibitors are needed for treatment of disorders in a host, including a human, associated with misregulation of the complement cascade.

SUMMARY

According to the present invention, a compound of Formula I is provided:

as well as the pharmaceutically acceptable salts and compositions thereof. Formula I can be considered to have a central core, an L-B substituent, and a (C═O)A substituent. It has been discovered that a compound of Formula I, or a pharmaceutically acceptable salt or composition thereof, is a superior inhibitor of complement factor D, and therefore can be used as an effective amount to treat a host in need of complement factor D modulation. As described below, the invention provides compounds of Formula I, wherein either X² is nitrogen or at least one of (d), (e), (g), (i), (l), (n), (p), (s), (v), (x), and (y) is present, as defined below. Pharmaceutical compositions comprising a compound or salt of Formula I together with a pharmaceutically acceptable carrier are also disclosed.

In one embodiment, a method for the treatment of a disorder associated with a dysfunction, including increased activity, of the complement pathway is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier, as described in more detail below.

In one embodiment, the disorder is associated with the alternative complement cascade pathway. In yet another embodiment, the disorder is associated with the complement classical pathway. In a further embodiment, the disorder is associated with the complement lectin pathway. The factor D inhibitors provided herein can thus dampen or inhibit detrimental complement activity in a host, by administration of an effective amount in a suitable manner to a host in need thereof.

Specific embodiments of this invention are directed to certain disease indications. In one embodiment, a method for the treatment of paroxysmal nocturnal hemoglobinuria (PNH) is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier. In another embodiment, a method for the treatment of age-related macular degeneration (AMD) is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier. In another embodiment, a method for the treatment of rheumatoid arthritis is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier. In another embodiment, a method for the treatment of multiple sclerosis is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier.

In other embodiments of the invention, an active compound provided herein can be used to treat or prevent a disorder in a host mediated by complement factor D, or by an excessive or detrimental amount of the C3 amplification loop of the complement pathway. As examples, the invention includes methods to treat or prevent complement associated disorders that are induced by antibody-antigen interactions, a component of an immune or autoimmune disorder or by ischemic injury. The invention also provides methods to decrease inflammation or an immune response, including an autoimmune response, where mediated or affected by factor D.

Formula I carries variables, e.g, A, B, L, X¹, X², Q¹, Q², and Q³, with the following definitions.

Q¹ is N(R¹) or C(R¹R^(1′)).

Q² is C(R²R^(2′)), C(R²R^(2′))—C(R²R^(2′)), S, O, N(R²) or C(R²R^(2′))O.

Q³ is N(R³), S, or C(R³R^(3′)).

(a) X¹ and X² are independently N, CH, or CZ, or (b) X¹ and X² together are C═C.

Q¹, Q², Q³, X¹, and X² are selected such that a stable compound results.

Non-limiting examples of the

ring are illustrated below (any of which can be otherwise substituted with R¹, R^(1′), R², R^(2′), R³, and R^(3′)) as described in more detail below.

wherein q is 0, 1, 2 or 3 and r is 1, 2 or 3.

R and R′ are independently chosen from H, alkyl, cycloalkyl, alkylcycloalkyl, cycloalkylalkyl, heterocycle, heterocycloalkyl, aryl, aralkyl, heteroaryl, heteroarylalkyl wherein each group can be optionally substituted or any other substituent group herein that provides the desired properties. In some embodiments, the ring includes one or more chiral carbon atoms. The invention includes embodiments in which the chiral carbon can be provided as an enantiomer, or mixtures of enantiomers, including a racemic mixture. Where the ring includes more than one stereocenter, all of the enantiomers and diastereomers are included in the invention as individual species.

Z is F, Cl, NH₂, CH₃, CH₂D, CHD₂, or CD₃.

R¹, R^(1′), R², R^(2′), R³, and R^(3′) are independently chosen at each occurrence from (c) and (d):

(c) hydrogen, halogen, hydroxyl, nitro, cyano, amino, C₁-C₆alkyl, C₂-C₆alkenyl, C₁-C₆alkoxy, C₂-C₆alkynyl, C₂-C₆alkanoyl, C₁-C₆thioalkyl, hydroxyC₁-C₆alkyl, aminoC₁-C₆alkyl, —C₀-C₄alkylNR⁹R¹⁰, —C(O)OR⁹, —OC(O)R⁹, —NR⁹C(O)R¹⁰, —C(O)NR⁹R¹⁰, —OC(O)NR⁹R¹⁰, —O(heteroaryl), —NR⁹C(O)OR¹⁰, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, where R⁹ and R¹⁰ are independently chosen at each occurrence from hydrogen, C₁-C₆alkyl, and (C₃-C₇cycloalkyl)C₀-C₄alkyl;

(d) —C₀-C₄alkyl(C₃-C₇cycloalkyl) and —O—C₀-C₄alkyl(C₃-C₇cycloalkyl).

In alternative embodiments, any one of the following rings (e), (f), (g), (h), (i), or (j) may be present:

(e) R¹ and R^(1′) or R³ and R^(3′) may be taken together to form a 3- to 6-membered carbocyclic spiro ring or a 3- to 6-membered heterocyclic spiro ring containing 1 or 2 heteroatoms independently chosen from N, O, or S;

(f) R² and R^(2′) may be taken together to form a 3- to 6-membered carbocyclic spiro ring,

(g) R² and R^(2′) may be taken together to form a 3- to 6-membered heterocyclic spiro ring,

each of which spiro rings (e), (f), and (g) is unsubstituted or substituted with 1 or more substituents independently chosen from halogen (and in particular F), hydroxyl, cyano, —COOH, C₁-C₄alkyl (including in particular methyl), C₂-C₄alkenyl, C₂-C₄alkynyl, C₁-C₄alkoxy, C₂-C₄alkanoyl, hydroxyC₁-C₄alkyl, (mono- and di-C₁-C₄alkylamino)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —O—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

(h) R¹ and R² may be taken together to form a 3-membered carbocyclic ring;

(i) R¹ and R² may be taken together to form a 4- to 6-membered carbocyclic ring or a 4- to 6-membered heterocyclic ring containing 1 or 2 heteroatoms independently chosen from N, O, and S.

(j) R² and R³, if bound to adjacent carbon atoms, may be taken together to form a 3- to 6-membered carbocyclic ring or a 3- to 6-membered heterocyclic ring; each of which ring (h), (i), and (j) may be unsubstituted or substituted with 1 or more substituents independently chosen from halogen (and in particular F), hydroxyl, cyano, —COOH, C₁-C₄alkyl (including in particular methyl), C₂-C₄alkenyl, C₂-C₄alkynyl, C₁-C₄alkoxy, C₂-C₄alkanoyl, hydroxyC₁-C₄alkyl, (mono- and di-C₁-C₄alkylamino)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —O—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

In alternative embodiments, R¹ and R^(1′), R² and R^(2′), or R³ and R^(3′) can be taken together to form a carbonyl group. In alternative embodiments, R¹ and R² or R² and R³ can be taken together to form a carbon-carbon double bond.

A is a group chosen from (k) and (l) where (k) is

and (l) is

X⁴ is B(OH) and Y is CHR⁹; or X⁴ is CHR⁹ and Y is B(OH).

R¹⁰¹ is hydrogen, alkyl, carboxy.

R⁴ is (m) or (n):

-   -   (m) —CHO, —CONH₂, or C₂-C₆alkanoyl, including         C(O)C₃-C₇cycloalkyl;     -   (n) hydrogen, —SO₂NH₂, —C(CH₂)₂F, —CH(CF₃)NH₂, C₁-C₆alkyl,         —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C(O)C₀-C₂alkyl(C₃-C₇cycloalkyl),

each of which R⁴ other than hydrogen, —CHO, and —CONH₂, is unsubstituted or substituted with one or more of amino, imino, halogen, hydroxyl, cyano, cyanoimino, C₁-C₂alkyl, C₁-C₂alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

R⁵ and R⁶ are independently chosen from (o) and (p):

(o) —CHO, —C(O)NH₂, —C(O)NH(CH₃), or C₂-C₆alkanoyl;

(p) hydrogen, hydroxyl, halogen, cyano, nitro, —COOH, —SO₂NH₂, —C(NH₂)C₁-C₃alkyl, —C(NH₂)C₁-C₃haloalkyl, —CF(C═CH₂), —C(═NCN)C₁-C₆alkyl, C₁-C₆alkyl, C₂-C₆alkenyl, C₁-C₆alkoxy, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C(O)C₀-C₄alkyl(C₃-C₇cycloalkyl), —P(O)(OR⁹)₂, —OC(O)R⁹, —C(O)OR⁹, —C(O)N(CH₂CH₂R⁹)(R¹⁰), —NR⁹C(O)R¹⁰, phenyl, or 5- to 6-membered heteroaryl.

Each R⁵ and R⁶ other than hydrogen, hydroxyl, cyano, and —COOH is unsubstituted or optionally substituted. For example, R⁵ and R⁶ other than hydrogen, hydroxyl, cyano, and —COOH may be substituted with one or more substituents independently chosen from halogen, hydroxyl, amino, imino, cyano, cyanoimino, C₁-C₂alkyl, C₁-C₄alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₂haloalkyl, C₁-C₂haloalkoxy, C(O)alkyl, C(O)cycloalkyl, C(O)aryl, C(O)heterocycle, and C(O)heteroaryl.

R^(6′) is hydrogen, halogen, hydroxyl, C₁-C₄alkyl, or C₁-C₄alkoxy; or R⁶ and R^(6′) may be taken together to form an oxo, vinyl, or imino group.

R⁷ is hydrogen, C₁-C₆alkyl, or —C₀-C₄alkyl(C₃-C₇cycloalkyl).

In an alternate embodiment, two A groups can be bonded together to form a dimer through a suitable linking group that achieves the desired purpose. Examples of linking groups include but are not limited to, urea, amide, —C(O)—C(O)—, carbamate and ketone. In one embodiment, two heteroaryl rings, for example, two indole rings, are linked through a urea to form the dimer.

R⁸ and R^(8′) are independently chosen from hydrogen, halogen, hydroxyl, C₁-C₆alkyl, C₁-C₆alkoxy, and (C₁-C₄alkylamino)C₀-C₂alkyl, or R⁸ and R^(8′) are taken together to form an oxo group, or can be taken together with the carbon that they are bonded to form a 3-membered carbocyclic ring.

R¹⁶ is 0 or 1 or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

R¹⁹ is hydrogen, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, —SO₂C₁-C₆alkyl, (mono- and di-C₁-C₆alkylamino)C₁-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C₀-C₄alkyl(C₃-C₇heterocycloalkyl), —C₀-C₄alkyl(aryl), C₀-C₄alkyl(heteroaryl), and —C(O)(CH₂)₁₋₂C(O)OR⁹ each of which R¹⁹ other than hydrogen is substituted with 0 or 1 or more substituents independently chosen from halogen, hydroxyl, amino, —COOH, and —C(O)OC₁-C₄alkyl.

X¹¹ is N or CR¹¹.

X¹² is N or CR¹².

X¹³ is N or CR¹³.

X¹⁴ is N or CR¹⁴.

No more than two of X¹¹, X¹², X¹³, and X¹⁴ are N.

R¹¹, R¹⁴, and R¹⁵ are independently chosen at each occurrence from hydrogen, halogen, hydroxyl, nitro, cyano, —NR⁹C(O)R¹⁰, C(O)NR⁹R¹⁰, —O(PO)(OR⁹)₂, —(PO)(OR⁹)₂, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkenyl(aryl), C₂-C₆alkenyl(cycloalkyl), C₂-C₆alkenyl(heterocycle), C₂-C₆alkenyl(heteroaryl), C₂-C₆alkynyl, C₂-C₆alkynyl(aryl), C₂-C₆alkynyl(cycloalkyl), C₂-C₆alkynyl(heterocycle), C₂-C₆alkynyl(heteroaryl), C₂-C₆alkanoyl, C₁-C₆alkoxy, C₁-C₆thioalkyl, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl), (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated heterocycle or heteroaryl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S), —C₀-C₄alkoxy(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

Alternatively, R¹³ and R¹⁴ can together form a bridge that can be an optionally substituted cycloalkyl, heterocycle or heteroaryl ring.

R¹² and R¹³ are independently chosen at each occurrence from (q), (r) and (s).

(q) hydrogen, halogen, hydroxyl, nitro, cyano, amino, —COOH, C₁-C₂haloalkyl, C₁-C₂haloalkoxy;

(r) C₁-C₆alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, C₂-C₆alkenyloxy, —C(O)OR⁹, C₁-C₆thioalkyl, —C₀-C₄alkylNR⁹R¹⁰, —C(O)NR⁹R¹⁰, —SO₂R⁹, —SO₂NR⁹R¹⁰, —OC(O)R⁹, and —C(NR⁹)NR⁹R¹⁰, each of which (r) is unsubstituted or substituted with one or more substituents independently selected from halogen, hydroxyl, nitro, cyano, amino, —COOH, —CONH₂, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, and each of which (r) is also optionally substituted with one substituent chosen from phenyl and 4- to 7-membered heterocycle containing 1, 2, or 3 heteroatoms independently chosen from N, O, and S; which phenyl or 4- to 7-membered heterocycle is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —(C₀-C₄alkyl)(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy;

(s) —C(CH₂)₂R³⁰.

R³⁰ is —NR⁹C(O)R³¹ or R³².

R³¹ and R³² are each independently selected from C₁-C₆alkyl, C₁-C₆haloalkyl, C₂-C₆alkenyl, C₂-C₆alkynyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl, (aryl)C₀-C₄alkyl, (heterocycle)C₀-C₄alkyl and (heteroaryl)C₀-C₄alkyl wherein each group can be optionally substituted; or each of which (s) may be unsubstituted or substituted with one or more substituents independently chosen from, but not limited to, halogen, hydroxyl, nitro, cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂, —P(O)(OH)₂, C₁-C₆alkyl, C₁-C₆alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₆alkylester, C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

L is either (t), (u), or (v):

(t) is a group of the formula

where R¹⁷ is hydrogen or C₁-C₆alkyl and R¹⁸ and R^(18′) are independently chosen from hydrogen, halogen, hydroxymethyl, and methyl; and m is 0, 1, 2, or 3;

(u) is a bond,

(v) or a directly linked optionally substituted alkyl, alkyl(heteroaryl), heterocyclic aryl, heteroaryl, moiety including but not limited to:

B is a monocyclic, bicyclic carbocyclic or carbocyclic-oxy group or a monocyclic, bicyclic, or tricyclic heterocyclic group having 1, 2, 3, or 4 heteroatoms independently selected from N, O, and S and from 4 to 7 ring atoms per ring, or B is a C₂-C₆alkenyl or C₂-C₆alkynyl group, or B is —(C₀-C₄alkyl)(aryl), —(C₀-C₄alkyl)(heteroaryl), or —(C₀-C₄alkyl)(biphenyl).

Each of which B is unsubstituted or substituted with one or more substituents independently chosen from (w) and (x) and 0 or 1 substituents chosen from (y) and (z):

(w) halogen, hydroxyl, —COOH, cyano, C₁-C₆alkyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkylNR⁹R¹⁰, —SO₂R⁹, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy;

(x) nitro, C₂-C₆alkenyl, C₂-C₆alkynyl, C₁-C₆thioalkyl, -JC₃-C₇cycloalkyl, —B(OH)₂, -JC(O)NR⁹R²³, -JOSO₂OR²¹, —C(O)(CH₂)₁₋₄S(O)R²¹, SR⁹, —O(CH₂)₁₋₄S(O)NR²¹R²², -JOP(O)(OR²¹)(OR²²), -JP(O)(OR²¹)(OR₂₂), -JOP(O)(OR²¹)R²², -JP(O)(OR²¹)R²², -JOP(O)R²¹R²², -JP(O)R²¹R²², -JSP(O)(OR²¹)(OR²²), -JSP(O)(OR²¹)(R²²), -JSP(O)(R²¹)(R²²), -JNR⁹P(O)(NHR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(OR²²), -JC(S)R²¹, -JNR²¹SO₂R²², -JNR⁹S(O)NR¹⁰R²², —JNR⁹SO₂NR¹⁰R²², -JSO₂NR⁹COR²², -JSO₂NR⁹CONR²¹R²², -JNR²¹SO₂R²², -JC(O)NR²¹SO₂R²², -JC(NH₂)NR²², -JC(NH₂)NR⁹S(O)₂R²², -JOC(O)NR²¹R²², -JNR²¹C(O)OR²², -JNR²¹OC(O)R²², —(CH₂)₁₋₄C(O)NR²¹R²², -JC(O)R²⁴R²⁵, -JNR⁹C(O)R²¹, -JC(O)R²¹, -JNR⁹C(O)NR¹⁰R²², —CCR²¹, —(CH₂)₁₋₄OC(O)R²¹, and -JC(O)OR²³; each of which (x) may be unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂, —P(O)(OH)₂, C₁-C₆alkyl, C₁-C₆alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₆alkylester, C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy;

(y) naphthyl, naphthyloxy, indanyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl containing 1 or 2 heteroatoms chosen from N, O, and S, and bicyclic heterocycle containing 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and containing 4- to 7-ring atoms in each ring; each of which (y) is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; and (z) tetrazolyl, (phenyl)C₀-C₂alkyl, (phenyl)C₁-C₂alkoxy, phenoxy, and 5- or 6-membered heteroaryl containing 1, 2, or 3 heteroatoms independently chosen from N, O, B, and S, each of which (z) is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, —OSi(CH₃)₂C(CH₃)₃, —Si(CH₃)₂C(CH₃)₃, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

J is independently chosen at each occurrence from a covalent bond, C₁-C₄alkylene, —OC₁-C₄alkylene, C₂-C₄alkenylene, and C₂-C₄alkynylene.

R²¹ and R²² are independently chosen at each occurrence from hydrogen, hydroxyl, cyano, amino, C₁-C₆alkyl, C₁-C₆haloalkyl, C₁-C₆alkoxy, (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, —C₁-C₄alkylOC(O)OC₁-C₆alkyl, —C₁-C₄alkylOC(O)C₁-C₆alkyl, —C₁-C₄alkylC(O)OC₁-C₆alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S.

R²³ is independently chosen at each occurrence from (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S.

R²⁴ and R²⁵ are taken together with the nitrogen to which they are attached to form a 4- to 7-membered monocyclic heterocycloalkyl group, or a 6- to 10-membered bicyclic heterocyclic group having fused, spiro, or bridged rings.

Either X² is nitrogen or at least one of (d), (e), (g), (i), (l), (n), (p), (s), (v), (x), and (y) is present. Pharmaceutical compositions comprising a compound or salt of Formula I together with a pharmaceutically acceptable carrier are also disclosed.

Methods of treating or preventing disorders mediated by complement cascade factor D, including but not limited to age-related macular degeneration (AMD), retinal degeneration, other ophthalmic diseases (e.g., geographic atrophy), paroxysymal nocturnal hemoglobinuria (PNH), multiple sclerosis (MS), arthritis including rheumatoid arthritis (RA), a respiratory disease or a cardiovascular disease, are provided, comprising administering a therapeutically effective amount of a compound or salt of Formula I to a host, including a human, in need of such treatment are also disclosed.

In another embodiment, an effective amount of an active factor D inhibiting compound is provided to treat an inflammatory or immune disorder, including an autoimmune disorder, that is mediated or affected by factor D. In an alternative embodiment, the compound of Formula I can be used to treat a disorder mediated by the complement pathway, regardless whether it is acting through Factor D.

The present invention includes at least the following features:

(a) a compound of Formula I as described herein, and pharmaceutically acceptable salts and prodrugs thereof (each of which and all subgenuses and species thereof considered individually and specifically described);

(b) Formula I as described herein, and pharmaceutically acceptable salts and prodrugs thereof, for use in treating or preventing disorders mediated by the complement pathway, and for example, cascade factor D, including age-related macular degeneration (AMD), retinal degeneration, paroxysymal nocturnal hemoglobinuria (PNH), multiple sclerosis (MS), and rheumatoid arthritis (RA) and other disorders described further herein;

(c) use of Formula I, and pharmaceutically acceptable salts and prodrugs thereof in the manufacture of a medicament for use in treating or preventing disorders mediated by complement cascade factor D, including age-related macular degeneration (AMD), retinal degeneration, paroxysymal nocturnal hemoglobinuria (PNH), multiple sclerosis (MS), and rheumatoid arthritis (RA) and other disorders described further herein;

(d) a process for manufacturing a medicament intended for the therapeutic use for treating or preventing treating or preventing disorders mediated by complement cascade factor D, including age-related macular degeneration (AMD), retinal degeneration, paroxysymal nocturnal hemoglobinuria (PNH), multiple sclerosis (MS), and rheumatoid arthritis (RA) and other disorders described further herein characterized in that Formula I as described herein is used in the manufacture;

(e) a pharmaceutical formulation comprising an effective host-treating amount of the Formula I or a pharmaceutically acceptable salt or prodrug thereof together with a pharmaceutically acceptable carrier or diluent;

(f) Formula I as described herein in substantially pure form, including substantially isolated from other chemical entities (e.g., at least 90 or 95%);

(g) processes for the manufacture of the compounds of Formula I and salts, compositions, dosage forms thereof, and

(h) processes for the preparation of therapeutic products that contain an effective amount of Formula I, as described herein.

DETAILED DESCRIPTION I. Terminology

Compounds are described using standard nomenclature. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as is commonly understood by one of skill in the art to which this invention belongs.

The compounds in any of the Formulas described herein include enantiomers, mixtures of enantiomers, diastereomers, tautomers, racemates and other isomers, such as rotamers, as if each is specifically described. “Formula I” includes all subgeneric groups of Formula I, such as Formula IA and Formula IB and also includes pharmaceutically acceptable salts of a compound of Formula I, unless clearly contraindicated by the context in which this phrase is used. “Formula I” also includes all subgeneric groups of Formula I, such as Formulas IC-ID, and Formulas II-XXX, and also includes pharmaceutically acceptable salts of all subgeneric groups of Formula I, such as Formulas IA-ID, and Formulas II-XXX, unless contraindicated by the context in which this phrase is used.

The terms “a” and “an” do not denote a limitation of quantity, but rather denote the presence of at least one of the referenced item. The term “or” means “and/or”. Recitation of ranges of values are merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein. The endpoints of all ranges are included within the range and independently combinable. All methods described herein can be performed in a suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of examples, or exemplary language (e.g., “such as”), is intended merely to better illustrate the invention and does not pose a limitation on the scope of the invention unless otherwise claimed. Unless defined otherwise, technical and scientific terms used herein have the same meaning as is commonly understood by one of skill in the art to which this invention belongs.

The present invention includes compounds of Formula I and the use of compounds with at least one desired isotopic substitution of an atom, at an amount above the natural abundance of the isotope, i.e., enriched. Isotopes are atoms having the same atomic number but different mass numbers, i.e., the same number of protons but a different number of neutrons.

Examples of isotopes that can be incorporated into compounds of the invention include isotopes of hydrogen, carbon, nitrogen, oxygen, phosphorous, fluorine, and chlorine, such as ²H, ³H, ¹¹C, ¹³C, ¹⁴C, ¹⁵N, ¹⁸F, ³¹P, ³²P, ³⁵S, ³⁶CI, ¹²⁵I respectively. The invention includes various isotopically labeled compounds as defined herein, for example those into which radioactive isotopes, such as ³H, ¹³C, and ¹⁴C, are present. Such isotopically labelled compounds are useful in metabolic studies (with ¹⁴C), reaction kinetic studies (with, for example ²H or ³H), detection or imaging techniques, such as positron emission tomography (PET) or single-photon emission computed tomography (SPECT) including drug or substrate tissue distribution assays, or in radioactive treatment of patients. In particular, an ¹⁸F labeled compound may be particularly desirable for PET or SPECT studies. Isotopically labeled compounds of this invention and prodrugs thereof can generally be prepared by carrying out the procedures disclosed in the schemes or in the examples and preparations described below by substituting a readily available isotopically labeled reagent for a non-isotopically labeled reagent.

By way of general example and without limitation, isotopes of hydrogen, for example, deuterium (²H) and tritium (³H) may be used anywhere in described structures. Alternatively or in addition, isotopes of carbon, e.g., ¹³C and ¹⁴C, may be used. A typical isotopic substitution is deuterium for hydrogen at one or more locations on the molecule to improve the performance of the drug, for example, the pharmacodynamics, pharmacokinetics, biodistribution, half-life, stability, AUC, Tmax, Cmax, etc. For example, the deuterium can be bound to carbon in a location of bond breakage during metabolism (an α-deuterium kinetic isotope effect) or next to or near the site of bond breakage (a β-deuterium kinetic isotope effect).

Isotopic substitutions, for example deuterium substitutions, can be partial or complete. Partial deuterium substitution means that at least one hydrogen is substituted with deuterium. In certain embodiments, the isotope is 90, 95 or 99% or more enriched in an isotope at any location of interest. In one embodiments deuterium is 90, 95 or 99% enriched at a desired location. Unless otherwise stated, the enrichment at any point is above natural abundance and enough to alter a detectable property of the drug in a human.

In one embodiment, the substitution of a hydrogen atom for a deuterium atom occurs within an R group substituent on the L-B moiety region. In one embodiment, the substitution of a hydrogen atom for a deuterium atom occurs within an R group selected from any of R¹⁸, R^(18′), R³³, R³⁴, R³⁵, and/or R³⁶. In one embodiment, the substitution of a hydrogen atom for a deuterium atom occurs within an R group substituent within the A-carbonyl moiety region. In one embodiment, the substitution of a hydrogen atom for a deuterium atom occurs at R⁴, R⁵, R⁶, R^(6′), R⁷, R⁸, R^(8′), R¹¹, R¹², R¹³, R¹⁴, R¹⁵, R¹⁶, R¹⁹, R²¹, R²², R²³, and R³⁰. In other embodiments, certain substituents on the proline ring are selectively deuterated. For example, in one embodiment, the substitution of a hydrogen atom for a deuterium atom occurs at R, R′, R¹, R^(1′), R², R^(2′), R³, and/or R^(3′). In one embodiment, for example, when any of the R substituents of the proline ring are methyl or methoxy, the alkyl residue is optionally deuterated, e.g., CD₃ or OCD₃. In certain other embodiments, when two substituents of the proline ring are combined to form a cyclopropyl ring, the unsubstituted methylene carbon is deuterated.

In one embodiment, the substitution of a hydrogen atom for a deuterium atom occurs within an R group when at least one of the variables within the R group is hydrogen (e.g., ²H or D) or alkyl (e.g., CD₃). For example, when any of R groups are, or contain for example through substitution, methyl or ethyl, the alkyl residue is typically deuterated, e.g., CD₃, CH₂CD₃ or CD₂CD₃. In certain other embodiments, when any of the above mentioned R groups are hydrogen, the hydrogen may be isotopically enriched as deuterium (i.e., ²H).

The compounds of the present invention may form solvates with solvents (including water). The term “solvate” refers to a molecular complex of a compound of the present invention (including salts thereof) with one or more solvent molecules. Solvents include water, ethanol, dimethyl sulfoxide, acetone and other common organic solvents. The term “hydrate” refers to a molecular complex comprising a compound of the invention and water. Pharmaceutically acceptable solvates in accordance with the invention include those wherein the solvent of crystallization may be isotopically substituted, e.g. D₂O, d₆-acetone, d₆-DMSO. A solvate can be in a liquid or solid form.

A dash (“-”) that is not between two letters or symbols is used to indicate a point of attachment for a substituent. For example, —(C═O)NH₂ is attached through carbon of the keto (C═O) group.

The term “substituted”, as used herein, means that any one or more hydrogens on the designated atom or group is replaced with a moiety selected from the indicated group, provided that the designated atom's normal valence is not exceeded. For example, when the substituent is oxo (i.e., ═O) then two hydrogens on the atom are replaced. When an oxo group replaces two hydrogens in an aromatic moiety, the corresponding partially unsaturated ring replaces the aromatic ring. For example a pyridyl group substituted by oxo is a pyridone. Combinations of substituents and/or variables are permissible only if such combinations result in stable compounds or useful synthetic intermediates.

A stable compound or stable structure refers to a compound leading to a compound that can be isolated and can be formulated into a dosage form with a shelf life of at least one month.

Any suitable group may be present on a “substituted” or “optionally substituted” position that forms a stable molecule and advances the desired purpose of the invention and includes, but is not limited to, e.g., halogen (which can independently be F, Cl, Br or I); cyano; hydroxyl; nitro; azido; alkanoyl (such as a C₂-C₆ alkanoyl group); carboxamide; alkyl, cycloalkyl, alkenyl, alkynyl, alkoxy, aryloxy such as phenoxy; alkylthio including those having one or more thioether linkages; alkylsulfinyl; alkylsulfonyl groups including those having one or more sulfonyl linkages; aminoalkyl groups including groups having one or more N atoms; aryl (e.g., phenyl, biphenyl, naphthyl, or the like, each ring either substituted or unsubstituted aromatic); arylalkyl having for example, 1 to 3 separate or fused rings and from 6 to about 14 or 18 ring carbon atoms, with benzyl being an exemplary arylalkyl group; arylalkoxy, for example, having 1 to 3 separate or fused rings with benzyloxy being an exemplary arylalkoxy group; or a saturated, unsaturated, or aromatic heterocyclic group having 1 to 3 separate or fused rings with one or more N, O or S atoms, e.g. coumarinyl, quinolinyl, isoquinolinyl, quinazolinyl, pyridyl, pyrazinyl, pyrimidinyl, furanyl, pyrrolyl, thienyl, thiazolyl, triazinyl, oxazolyl, isoxazolyl, imidazolyl, indolyl, benzofuranyl, benzothiazolyl, tetrahydrofuranyl, tetrahydropyranyl, piperidinyl, morpholinyl, piperazinyl, and pyrrolidinyl. Such heterocyclic groups may be further substituted, e.g. with hydroxy, alkyl, alkoxy, halogen and amino. In certain embodiments “optionally substituted” includes one or more substituents independently chosen from halogen, hydroxyl, amino, cyano, —CHO, —COOH, —CONH₂, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkynyl, —C₁-C₆alkoxy, C₂-C₆alkanoyl, C₁-C₆alkylester, (mono- and di-C₁-C₆alkylamino)C₀-C₂alkyl, C₁-C₂haloalkyl, hydoxyC₁-C₆alkyl, ester, carbamate, urea, sulfonamide, —C₁-C₆alkyl(heterocyclo), C₁-C₆alkyl(heteroaryl), —C₁-C₆alkyl(C₃-C₇cycloalkyl), O—C₁-C₆alkyl(C₃-C₇cycloalkyl), B(OH)₂, phosphate, phosphonate and C₁-C₂haloalkoxy.

“Alkyl” is a branched or straight chain saturated aliphatic hydrocarbon group. In one embodiment, the alkyl contains from 1 to about 12 carbon atoms, more generally from 1 to about 6 carbon atoms or from 1 to about 4 carbon atoms. In one embodiment, the alkyl contains from 1 to about 8 carbon atoms. In certain embodiments, the alkyl is C₁-C₂, C₁-C₃, or C₁-C₆. The specified ranges as used herein indicate an alkyl group having each member of the range described as an independent species. For example, the term C₁-C₆ alkyl as used herein indicates a straight or branched alkyl group having from 1, 2, 3, 4, 5, or 6 carbon atoms and is intended to mean that each of these is described as an independent species. For example, the term C₁-C₄alkyl as used herein indicates a straight or branched alkyl group having from 1, 2, 3, or 4 carbon atoms and is intended to mean that each of these is described as an independent species. When C₀-C_(n) alkyl is used herein in conjunction with another group, for example, (C₃-C₇cycloalkyl)C₀-C₄ alkyl, or —C₀-C₄alkyl(C₃-C₇cycloalkyl), the indicated group, in this case cycloalkyl, is either directly bound by a single covalent bond (C₀alkyl), or attached by an alkyl chain in this case 1, 2, 3, or 4 carbon atoms. Alkyls can also be attached via other groups such as heteroatoms as in —O—C₀-C₄alkyl(C₃-C₇cycloalkyl). Examples of alkyl include, but are not limited to, methyl, ethyl, n-propyl, isopropyl, n-butyl, isobutyl, sec-butyl, t-butyl, n-pentyl, isopentyl, tert-pentyl, neopentyl, n-hexyl, 2-methylpentane, 3-methylpentane, 2,2-dimethylbutane and 2,3-dimethylbutane. In one embodiment, the alkyl group is optionally substituted as described above.

“Alkenyl” is a branched or straight chain aliphatic hydrocarbon group having one or more carbon-carbon double bonds that may occur at a stable point along the chain. Nonlimiting examples are C₂-C₈alkenyl, C₂-C₆alkenyl and C₂-C₄alkenyl. The specified ranges as used herein indicate an alkenyl group having each member of the range described as an independent species, as described above for the alkyl moiety. Examples of alkenyl include, but are not limited to, ethenyl and propenyl. In one embodiment, the alkenyl group is optionally substituted as described above.

“Alkynyl” is a branched or straight chain aliphatic hydrocarbon group having one or more carbon-carbon triple bonds that may occur at any stable point along the chain, for example, C₂-C₈alkynyl or C₂-C₆alkynyl. The specified ranges as used herein indicate an alkynyl group having each member of the range described as an independent species, as described above for the alkyl moiety. Examples of alkynyl include, but are not limited to, ethynyl, propynyl, 1-butynyl, 2-butynyl, 3-butynyl, 1-pentynyl, 2-pentynyl, 3-pentynyl, 4-pentynyl, 1-hexynyl, 2-hexynyl, 3-hexynyl, 4-hexynyl and 5-hexynyl. In one embodiment, the alkynyl group is optionally substituted as described above.

“Alkylene” is a bivalent saturated hydrocarbon. Alkylenes, for example, can be a 1 to 8 carbon moiety, 1 to 6 carbon moiety, or an indicated number of carbon atoms, for example C₁-C₄alkylene, C₁-C₃alkylene, or C₁-C₂alkylene.

“Alkenylene” is a bivalent hydrocarbon having at least one carbon-carbon double bond. Alkenylenes, for example, can be a 2 to 8 carbon moiety, 2 to 6 carbon moiety, or an indicated number of carbon atoms, for example C₂-C₄alkenylene.

“Alkynylene” is a bivalent hydrocarbon having at least one carbon-carbon triple bond. Alkynylenes, for example, can be a 2 to 8 carbon moiety, 2 to 6 carbon moiety, or an indicated number of carbon atoms, for example C₂-C₄alkynylene.

“Alkoxy” is an alkyl group as defined above covalently bound through an oxygen bridge (—O—). Examples of alkoxy include, but are not limited to, methoxy, ethoxy, n-propoxy, i-propoxy, n-butoxy, 2-butoxy, t-butoxy, n-pentoxy, 2-pentoxy, 3-pentoxy, isopentoxy, neopentoxy, n-hexoxy, 2-hexoxy, 3-hexoxy, and 3-methylpentoxy. Similarly an “alkylthio” or a “thioalkyl” group is an alkyl group as defined above with the indicated number of carbon atoms covalently bound through a sulfur bridge (—S—). In one embodiment, the alkoxy group is optionally substituted as described above.

“Alkenyloxy” is an alkenyl group as defined covalently bound to the group it substitutes by an oxygen bridge (—O—).

“Alkanoyl” is an alkyl group as defined above covalently bound through a carbonyl (C═O) bridge. The carbonyl carbon is included in the number of carbons, that is C₂alkanoyl is a CH₃(C═O)— group. In one embodiment, the alkanoyl group is optionally substituted as described above.

“Alkylester” is an alkyl group as defined herein covalently bound through an ester linkage. The ester linkage may be in either orientation, e.g., a group of the formula —O(C═O)alkyl or a group of the formula —(C═O)Oalkyl.

“Amide” or “carboxamide” is —C(O)NR^(a)R^(b) wherein R^(a) and R^(b) are each independently selected from hydrogen, alkyl, for example, C₁-C₆alkyl, alkenyl, for example, C₂-C₆alkenyl, alkynyl, for example, C₂-C₆alkynyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C₀-C₄alkyl(C₃-C₇heterocycloalkyl), —C₀-C₄alkyl(aryl), and —C₀-C₄alkyl(heteroaryl); or together with the nitrogen to which they are bonded, R^(a) and R^(b) can form a C₃-C₇heterocyclic ring. In one embodiment, the R^(a) and R^(b) groups are each independently optionally substituted as described above.

“Carbocyclic group”, “carbocyclic ring”, or “cycloalkyl” is a saturated or partially unsaturated (i.e., not aromatic) group containing all carbon ring atoms. A carbocyclic group typically contains 1 ring of 3 to 7 carbon atoms or 2 fused rings each containing 3 to 7 carbon atoms. In one embodiment, a carbocyclic ring can be fused to an aryl ring. Cycloalkyl substituents may be pendant from a substituted nitrogen or carbon atom, or a substituted carbon atom that may have two substituents can have a cycloalkyl group, which is attached as a spiro group. Examples of carbocyclic rings include cyclohexenyl, cyclohexyl, cyclopentenyl, cyclopentyl, cyclobutenyl, cyclobutyl and cyclopropyl rings. In one embodiment, the carbocyclic ring is optionally substituted as described above. In one embodiment, the cycloalkyl is a partially unsaturated (i.e., not aromatic) group containing all carbon ring atoms. In another embodiment, the cycloalkyl is a saturated group containing all carbon ring atoms.

“Carbocyclic-oxy group” is a monocyclic carbocyclic ring or a mono- or bi-cyclic carbocyclic group as defined above attached to the group it substitutes via an oxygen, —O—, linker.

“Haloalkyl” indicates both branched and straight-chain alkyl groups substituted with 1 or more halogen atoms, up to the maximum allowable number of halogen atoms. Examples of haloalkyl include, but are not limited to, trifluoromethyl, monofluoromethyl, difluoromethyl, 2-fluoroethyl, and penta-fluoroethyl.

“Haloalkoxy” indicates a haloalkyl group as defined herein attached through an oxygen bridge (oxygen of an alcohol radical).

“Hydroxyalkyl” is an alkyl group as previously described, substituted with at least one hydroxyl substituent.

“Aminoalkyl” is an alkyl group as previously described, substituted with at least one amino substituent.

“Halo” or “halogen” indicates independently any of fluoro, chloro, bromo, and iodo.

“Aryl” indicates aromatic groups containing only carbon in the aromatic ring or rings. In one embodiment, the aryl groups contain 1 to 3 separate or fused rings and is 6 to about 14 or 18 ring atoms, without heteroatoms as ring members. When indicated, such aryl groups may be further substituted with carbon or non-carbon atoms or groups. Such substitution may include fusion to a 5 to 7-membered saturated cyclic group that optionally contains 1 or 2 heteroatoms independently chosen from N, O, and S, to form, for example, a 3,4-methylenedioxyphenyl group. Aryl groups include, for example, phenyl and naphthyl, including 1-naphthyl and 2-naphthyl. In one embodiment, aryl groups are pendant. An example of a pendant ring is a phenyl group substituted with a phenyl group. In one embodiment, the aryl group is optionally substituted as described above.

The term “heterocycle,” or “heterocyclic ring” as used herein refers to a saturated or a partially unsaturated (i.e., having one or more double and/or triple bonds within the ring without aromaticity) carbocyclic radical of 3 to about 12, and more typically 3, 5, 6, 7 to 10 ring atoms in which at least one ring atom is a heteroatom selected from nitrogen, oxygen, phosphorus and sulfur, the remaining ring atoms being C, where one or more ring atoms is optionally substituted independently with one or more substituents described above. A heterocycle may be a monocycle having 3 to 7 ring members (2 to 6 carbon atoms and 1 to 4 heteroatoms selected from N, O, P, and S) or a bicycle having 6 to 10 ring members (4 to 9 carbon atoms and 1 to 6 heteroatoms selected from N, O, P, and S), for example: a bicyclo [4,5], [5,5], [5,6], or [6,6] system. In one embodiment, the only heteroatom is nitrogen. In one embodiment, the only heteroatom is oxygen. In one embodiment, the only heteroatom is sulfur. Heterocycles are described in Paquette, Leo A.; “Principles of Modern Heterocyclic Chemistry” (W. A. Benjamin, New York, 1968), particularly Chapters 1, 3, 4, 6, 7, and 9; “The Chemistry of Heterocyclic Compounds, A series of Monographs” (John Wiley & Sons, New York, 1950 to present), in particular Volumes 13, 14, 16, 19, and 28; and J. Am. Chem. Soc. (1960) 82:5566. Examples of heterocyclic rings include, but are not limited to, pyrrolidinyl, dihydrofuranyl, tetrahydrothienyl, tetrahydropyranyl, dihydropyranyl, tetrahydrothiopyranyl, piperidino, piperidonyl, morpholino, thiomorpholino, thioxanyl, piperazinyl, homopiperazinyl, azetidinyl, oxetanyl, thietanyl, homopiperidinyl, oxepanyl, thiepanyl, oxazepinyl, diazepinyl, thiazepinyl, 2-pyrrolinyl, 3-pyrrolinyl, indolinyl, 2H-pyranyl, 4H-pyranyl, dioxanyl, 1,3-dioxolanyl, pyrazolinyl, dithianyl, dithiolanyl, dihydropyranyl, dihydrothienyl, dihydrofuranyl, dihydroisoquinolinyl, tetrahydroisoquinolinyl, pyrazolidinylimidazolinyl, imidazolidinyl, 2-oxa-5-azabicyclo[2.2.2]octane, 3-oxa-8-azabicyclo[3.2.1]octane, 8-oxa-3-azabicyclo[3.2.1]octane, 6-oxa-3-azabicyclo[3.1.1]heptane, 2-oxa-5-azabicyclo[2.2.1]heptane, 3-azabicyco[3.1.0]hexanyl, 3-azabicyclo[4.1.0]heptanyl, azabicyclo[2.2.2]hexanyl, 3H-indolyl, quinolizinyl, N-pyridyl ureas, and pyrrolopyrimidine. Spiro moieties are also included within the scope of this definition. Examples of a heterocyclic group wherein 1 or 2 ring carbon atoms are substituted with oxo (═O) moieties are pyrimidinonyl and 1,1-dioxo-thiomorpholinyl. The heterocycle groups herein are optionally substituted independently with one or more substituents described herein.

“Heterocyclicoxy group” is a monocyclic heterocyclic ring or a bicyclic heterocyclic group as described previously linked to the group it substitutes via an oxygen, —O—, linker.

“Heteroaryl” indicates a stable monocyclic aromatic ring which contains from 1 to 3, or in some embodiments from 1 to 2, heteroatoms chosen from N, O, and S, with remaining ring atoms being carbon, or a stable bicyclic or tricyclic system containing at least one 5- to 7-membered aromatic ring which contains from 1 to 3, or in some embodiments from 1 to 2, heteroatoms chosen from N, O, and S, with remaining ring atoms being carbon. In one embodiment, the only heteroatom is nitrogen. In one embodiment, the only heteroatom is oxygen. In one embodiment, the only heteroatom is sulfur. Monocyclic heteroaryl groups typically have from 5 to 7 ring atoms. In some embodiments bicyclic heteroaryl groups are 9- to 10-membered heteroaryl groups, that is, groups containing 9 or 10 ring atoms in which one 5- to 7-member aromatic ring is fused to a second aromatic or non-aromatic ring. When the total number of S and O atoms in the heteroaryl group exceeds 1, these heteroatoms are not adjacent to one another. In one embodiment, the total number of S and O atoms in the heteroaryl group is not more than 2. In another embodiment, the total number of S and O atoms in the aromatic heterocycle is not more than 1. Examples of heteroaryl groups include, but are not limited to, pyridinyl (including, for example, 2-hydroxypyridinyl), imidazolyl, imidazopyridinyl, pyrimidinyl (including, for example, 4-hydroxypyrimidinyl), pyrazolyl, triazolyl, pyrazinyl, tetrazolyl, furyl, thienyl, isoxazolyl, thiazolyl, oxadiazolyl, oxazolyl, isothiazolyl, pyrrolyl, quinolinyl, isoquinolinyl, tetrahydroisoquinolinyl, indolyl, benzimidazolyl, benzofuranyl, cinnolinyl, indazolyl, indolizinyl, phthalazinyl, pyridazinyl, triazinyl, isoindolyl, pteridinyl, purinyl, oxadiazolyl, triazolyl, thiadiazolyl, thiadiazolyl, furazanyl, benzofurazanyl, benzothiophenyl, benzothiazolyl, benzoxazolyl, quinazolinyl, quinoxalinyl, naphthyridinyl, tetrahydrofuranyl, and furopyridinyl. Heteroaryl groups are optionally substituted independently with one or more substituents described herein. “Heteroaryloxy” is a heteroaryl group as described bound to the group it substituted via an oxygen, —O—, linker.

“Heterocycloalkyl” is a saturated ring group. It may have, for example, 1, 2, 3, or 4 heteroatoms independently chosen from N, S, and O, with remaining ring atoms being carbon. In a typical embodiment, nitrogen is the heteroatom. Monocyclic heterocycloalkyl groups typically have from 3 to about 8 ring atoms or from 4 to 6 ring atoms. Examples of heterocycloalkyl groups include morpholinyl, piperazinyl, piperidinyl, and pyrrolinyl.

The term “mono- and/or di-alkylamino” indicates secondary or tertiary alkylamino groups, wherein the alkyl groups are independently chosen alkyl groups, as defined herein. The point of attachment of the alkylamino group is on the nitrogen. Examples of mono- and di-alkylamino groups include ethylamino, dimethylamino, and methyl-propyl-amino.

A “dosage form” means a unit of administration of an active agent. Examples of dosage forms include tablets, capsules, injections, suspensions, liquids, emulsions, implants, particles, spheres, creams, ointments, suppositories, inhalable forms, transdermal forms, buccal, sublingual, topical, gel, mucosal, and the like. A “dosage form” can also include an implant, for example an optical implant.

“Pharmaceutical compositions” are compositions comprising at least one active agent, such as a compound or salt of Formula I, and at least one other substance, such as a carrier. “Pharmaceutical combinations” are combinations of at least two active agents which may be combined in a single dosage form or provided together in separate dosage forms with instructions that the active agents are to be used together to treat any disorder described herein.

“Pharmaceutically acceptable salts” includes derivatives of the disclosed compounds in which the parent compound is modified by making inorganic and organic, non-toxic, acid or base addition salts thereof. The salts of the present compounds can be synthesized from a parent compound that contains a basic or acidic moiety by conventional chemical methods. Generally, such salts can be prepared by reacting free acid forms of these compounds with a stoichiometric amount of the appropriate base (such as Na, Ca, Mg, or K hydroxide, carbonate, bicarbonate, or the like), or by reacting free base forms of these compounds with a stoichiometric amount of the appropriate acid. Such reactions are typically carried out in water or in an organic solvent, or in a mixture of the two. Generally, non-aqueous media like ether, ethyl acetate, ethanol, isopropanol, or acetonitrile are typical, where practicable. Salts of the present compounds further include solvates of the compounds and of the compound salts.

Examples of pharmaceutically acceptable salts include, but are not limited to, mineral or organic acid salts of basic residues such as amines; alkali or organic salts of acidic residues such as carboxylic acids; and the like. The pharmaceutically acceptable salts include the conventional non-toxic salts and the quaternary ammonium salts of the parent compound formed, for example, from non-toxic inorganic or organic acids. For example, conventional non-toxic acid salts include those derived from inorganic acids such as hydrochloric, hydrobromic, sulfuric, sulfamic, phosphoric, nitric and the like; and the salts prepared from organic acids such as acetic, propionic, succinic, glycolic, stearic, lactic, malic, tartaric, citric, ascorbic, pamoic, maleic, hydroxymaleic, phenylacetic, glutamic, benzoic, salicylic, mesylic, esylic, besylic, sulfanilic, 2-acetoxybenzoic, fumaric, toluenesulfonic, methanesulfonic, ethane disulfonic, oxalic, isethionic, HOOC—(CH₂)_(n)—COOH where n is 0-4, and the like. Lists of additional suitable salts may be found, e.g., in Remington's Pharmaceutical Sciences, 17th ed., Mack Publishing Company, Easton, Pa., p. 1418 (1985).

The term “carrier” applied to pharmaceutical compositions/combinations of the invention refers to a diluent, excipient, or vehicle with which an active compound is provided.

A “pharmaceutically acceptable excipient” means an excipient that is useful in preparing a pharmaceutical composition/combination that is generally safe, non-toxic and neither biologically nor otherwise inappropriate for administration to a host, and includes, in one embodiment, an excipient that is acceptable for veterinary use as well as human pharmaceutical use. A “pharmaceutically acceptable excipient” as used in the present application includes both one and more than one such excipient.

A “patient” or “host” or “subject” is a human or non-human animal in need of modulation of the complement factor D pathway. Typically the host is a human. A “patient” or “host” or “subject” also refers to for example, mammals, primates (e.g., humans), cows, sheep, goats, horses, dogs, cats, rabbits, rats, mice, fish, birds and the like.

A “prodrug” as used herein, means a compound which when administered to a host in vivo is converted into a parent drug. As used herein, the term “parent drug” means any of the presently described chemical compounds that are useful to treat any of the disorders described herein, or to control or improve the underlying cause or symptoms associated with any physiological or pathological disorder described herein in a host, typically a human. Prodrugs can be used to achieve any desired effect, including to enhance properties of the parent drug or to improve the pharmaceutic or pharmacokinetic properties of the parent. Prodrug strategies exist which provide choices in modulating the conditions for in vivo generation of the parent drug, all of which are deemed included herein. Nonlimiting examples of prodrug strategies include covalent attachment of removable groups, or removable portions of groups, for example, but not limited to acylation, phosphorylation, phosphonylation, phosphoramidate derivatives, amidation, reduction, oxidation, esterification, alkylation, other carboxy derivatives, sulfoxy or sulfone derivatives, carbonylation or anhydride, among others.

“Providing a compound of Formula I with at least one additional active agent” means the compound of Formula I and the additional active agent(s) are provided simultaneously in a single dosage form, provided concomitantly in separate dosage forms, or provided in separate dosage forms for administration separated by some amount of time that is within the time in which both the compound of Formula I and the at least one additional active agent are within the blood stream of a patient. In certain embodiments the compound of Formula I and the additional active agent need not be prescribed for a patient by the same medical care worker. In certain embodiments the additional active agent or agents need not require a prescription. Administration of the compound of Formula I or the at least one additional active agent can occur via any appropriate route, for example, oral tablets, oral capsules, oral liquids, inhalation, injection, suppositories or topical contact.

A “therapeutically effective amount” of a pharmaceutical composition/combination of this invention means an amount effective, when administered to a patient, to provide a therapeutic benefit such as an amelioration of symptoms, e.g., an amount effective to decrease the symptoms of a macular degeneration. In one embodiment, a therapeutically effective amount is an amount sufficient to prevent a significant increase or will significantly reduce the detectable level of complement factor D in the patient's blood, serum, or tissues.

II. Detailed Description of the Active Compounds

According to the present invention, a compound of Formula I is provided:

as well as the pharmaceutically acceptable salts and compositions thereof. Formula I can be considered to have a central core, an L-B substituent, and a (C═O)A substituent. It has been discovered that a compound of Formula I, or a pharmaceutically acceptable salt or composition thereof, is a superior inhibitor of complement factor D, and therefore can be used as an effective amount to treat a host in need of complement factor D modulation.

Non-limiting examples of compounds falling within Formula I with variations in the variables e.g., A, B, R¹-R^(3′), and L, are illustrated below. The disclosure includes all combinations of these definitions so long as a stable compound results.

Formulas II-XXX

In one aspect, the disclosure includes compounds and salts of Formula II, III, IV, V, VI, VII, VIII, IX, X, XI, XII, XIII, XIV, XV, XVI, XVII, XVIII, XIX, XX, XXI, XXII, XXIII, XXIV, XXV, XXVI, XXVII, XXVIII, XXIX and XXX which are within the scope of Formula I. The variables shown in Formula II-XXX carry the definitions set forth in the SUMMARY section for Formula I or any of the definitions set forth in this disclosure.

Additionally, the disclosure includes compounds and salts of Formula I and pharmaceutically acceptable compositions thereof, and any of its subformulae (II-XXX) in which at least one of the following conditions is met in the embodiments described below.

The R¹² and R¹³ Substituents

It has been discovered that a compound of Formula I, a pharmaceutically acceptable salt or composition thereof, is a superior inhibitor of complement factor D.

In one embodiment, R¹² and R¹³ are independently chosen at each occurrence from (q), (r) and (s):

(q) hydrogen, halogen, hydroxyl, nitro, cyano, amino, —COOH, C₁-C₂haloalkyl, C₁-C₂haloalkoxy;

(r) C₁-C₆alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, C₂-C₆alkenyloxy, —C(O)OR⁹, C₁-C₆thioalkyl, —C₀-C₄alkylNR⁹R¹⁰, —C(O)NR⁹R¹⁰, —SO₂R⁹, —SO₂NR⁹R¹⁰, —OC(O)R⁹, and —C(NR⁹)NR⁹R¹⁰, each of which (r) is unsubstituted or substituted with one or more substituents independently selected from halogen, hydroxyl, nitro, cyano, amino, —COOH, —CONH₂, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, and each of which (r) is also optionally substituted with one substituent chosen from phenyl and 4- to 7-membered heterocycle containing 1, 2, or 3 heteroatoms independently chosen from N, O, and S; which phenyl or 4- to 7-membered heterocycle is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —(C₀-C₄alkyl)(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy;

(s) —C(CH₂)₂₋₄R³⁰.

R³⁰ is —NR⁹C(O)R³¹ or R³².

R³¹ and R³² are C₁-C₆alkyl, C₁-C₆haloalkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S.

Each of which (s) may be unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂, —P(O)(OH)₂, C₁-C₆alkyl, C₁-C₆alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₆alkylester, C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

In certain embodiments, R¹² or R¹³ are independently selected from:

Non-Limiting R¹²/R¹³ Embodiments

In one embodiment, the disclosure provides compounds of Formula I, wherein; one of R¹² and R¹³ is H and the other of R¹² and R¹³ is chosen from (s):

(s) —C(CH₂)₂R³⁰;

wherein R³⁰ is as defined in the summary section above.

In another embodiment, the disclosure provides compounds of Formula I, wherein;

R¹, R^(1′), R², and R^(3′) are all hydrogen;

R² is fluoro and R³ is hydrogen, —C₀-C₄alkyl(C₃₋₇cycloalkyl), or —O—C₀-C₄alkyl(C₃-C₇cycloalkyl);

R⁵ is hydrogen, halogen, or C₁-C₂alkyl;

R¹¹, R¹³, R¹⁴, and R¹⁵, if present, are independently chosen at each occurrence from hydrogen, halogen, hydroxyl, amino, C₁-C₄alkyl, C₁-C₄alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₂alkylamino), trifluoromethyl, and trifluoromethoxy;

X¹² is CR¹²; and

R¹² is chosen from (s):

(s) —C(CH₂)₂R³⁰;

wherein R³⁰ is as defined in the summary section above.

In one embodiment, the disclosure provides compounds of Formula I, wherein;

m is 0 or 1;

R² is halogen, R^(2′) is hydrogen or halogen, and R³ is hydrogen, halogen, —C₀-C₄alkyl(C₃-C₇cycloalkyl), or —O—C₀-C₄alkyl(C₃-C₇cycloalkyl);

R⁶ is —C(O)C₁-C₄alkyl, —C(O)NH₂, —C(O)CF₃, —C(O)(C₃-C₇cycloalkyl), or -ethyl(cyanoimino);

one of R¹² and R¹³ is selected from hydrogen, halogen, C₁-C₄alkyl, C₁-C₄alkoxy, trifluoromethyl, and trifluoromethoxy; the other of R¹² and R¹³ is chosen from (s):

(s) —C(CH₂)₂R³⁰;

wherein R³⁰ is as defined in the summary section above.

In one embodiment, the disclosure provides compounds of Formula I, wherein;

one of R¹² and R¹³ is hydrogen, hydroxyl, halogen, methyl, or methoxy; and the other of R¹² and R¹³ is chosen from (s):

(s) —C(CH₂)₂R³⁰;

wherein R³⁰ is as defined in the summary section above.

Central Core Moiety

The central core moiety in Formula I is illustrated below:

wherein:

Q¹ is N(R¹) or C(R¹R^(1′)).

Q² is C(R²R^(2′)), C(R²R^(2′))—C(R²R^(2′)), S, O, N(R²) or C(R²R^(2′))O.

Q³ is N(R³), S, or C(R³R^(3′)).

(a) X¹ and X² are independently N, CH, or CZ, or (b) X¹ and X² together are C═C.

Q¹, Q², Q³, X¹, and X² are selected such that a stable compound results.

Non-limiting examples of the

ring are illustrated below (any of which can be otherwise substituted with R¹, R^(1′), R², R^(2′), R³, and R^(3′)) as described in more detail below.

wherein q is 0, 1, 2 or 3 and r is 1, 2 or 3.

R and R′ are independently chosen from H, alkyl, cycloalkyl, alkylcycloalkyl, cycloalkylalkyl, heterocycle, heterocycloalkyl, aryl, aralkyl, heteroaryl, heteroarylalkyl wherein each group can be optionally substituted or any other substituent group herein that provides the desired properties. In some embodiments, the ring includes one or more chiral carbon atoms. The invention includes embodiments in which the chiral carbon can be provided as an enantiomer, or mixtures of enantiomers, including a racemic mixture. Where the ring includes more than one stereocenter, all of the enantiomers and diastereomers are included in the invention as individual species.

Z is F, Cl, NH₂, CH₃, CH₂D, CHD₂, or CD₃.

R¹, R^(1′), R², R^(2′), R³, and R^(3′) are independently chosen at each occurrence from (c) and (d):

(c) hydrogen, halogen, hydroxyl, nitro, cyano, amino, C₁-C₆alkyl, C₂-C₆alkenyl, C₁-C₆alkoxy, C₂-C₆alkynyl, C₂-C₆alkanoyl, C₁-C₆thioalkyl, hydroxyC₁-C₆alkyl, aminoC₁-C₆alkyl, —C₀-C₄alkylNR⁹R¹⁰, —C(O)OR⁹, —OC(O)R⁹, —NR⁹C(O)R¹⁰, —C(O)NR⁹R¹⁰, —OC(O)NR⁹R¹⁰, —O(heteroaryl), —NR⁹C(O)OR¹⁰, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, where R⁹ and R¹⁰ are independently chosen at each occurrence from hydrogen, C₁-C₆alkyl, and (C₃-C₇cycloalkyl)C₀-C₄alkyl;

(d) —C₀-C₄alkyl(C₃-C₇cycloalkyl) and —O—C₀-C₄alkyl(C₃-C₇cycloalkyl).

Non-Limiting Central Core Embodiments

In alternative embodiments, any one of the following rings (e), (f), (g), (h), (i), or (j) may be present:

(e) R¹ and R^(1′) or R³ and R^(3′) may be taken together to form a 3- to 6-membered carbocyclic spiro ring or a 3- to 6-membered heterocyclic spiro ring containing 1 or 2 heteroatoms independently chosen from N, O, or S;

(f) R² and R^(2′) may be taken together to form a 3- to 6-membered carbocyclic spiro ring,

(g) R² and R^(2′) may be taken together to form a 3- to 6-membered heterocyclic spiro ring, each of which spiro rings (e), (f), and (g) is unsubstituted or substituted with 1 or more substituents independently chosen from halogen (and in particular F), hydroxyl, cyano, —COOH, C₁-C₄alkyl (including in particular methyl), C₂-C₄alkenyl, C₂-C₄alkynyl, C₁-C₄alkoxy, C₂-C₄alkanoyl, hydroxyC₁-C₄alkyl, (mono- and di-C₁-C₄alkylamino)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —O—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

(h) R¹ and R² may be taken together to form a 3-membered carbocyclic ring;

(i) R¹ and R² may be taken together to form a 4- to 6-membered carbocyclic ring or a 4- to 6-membered heterocyclic ring containing 1 or 2 heteroatoms independently chosen from N, O, and S.

(j) R² and R³, if bound to adjacent carbon atoms, may be taken together to form a 3- to 6-membered carbocyclic ring or a 3- to 6-membered heterocyclic ring; each of which ring (h), (i), and (j) may be unsubstituted or substituted with 1 or more substituents independently chosen from halogen (and in particular F), hydroxyl, cyano, —COOH, C₁-C₄alkyl (including in particular methyl), C₂-C₄alkenyl, C₂-C₄alkynyl, C₁-C₄alkoxy, C₂-C₄alkanoyl, hydroxyC₁-C₄alkyl, (mono- and di-C₁-C₄alkylamino)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —O—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

In one embodiment, the central core moiety is proline.

In one embodiment, the central core moiety is 4-fluoroproline.

In one embodiment, R¹, R^(1′), R^(2′), R³, and R^(3′), if present, are all hydrogen; and R² is fluoro.

In one embodiment, R¹, R^(1′), R^(2′), and R^(3′), if present, are all hydrogen; and R² is fluoro and R³ is —C₀-C₄alkyl(C₃-C₇cycloalkyl) or —O—C₀-C₄alkyl(C₃-C₇cycloalkyl).

In one embodiment, R¹ and R² are taken together to form a 3- to 6-membered cycloalkyl group, and R^(1′), R^(2′), R³, and R^(3′), where present, are all hydrogen.

In one embodiment, R¹, R^(1′), R³, and R^(3′), if present, are all hydrogen, and R² and R^(2′) are taken together to form a 5- or 6-membered heterocycloalkyl group having 1 or 2 oxygen atoms.

In one embodiment, R¹ is hydrogen and R² is fluoro.

In one embodiment, R¹ and R² are joined to form a 3 membered ring.

The disclosure includes compounds of Formula I in which the central pyrrolidine is vinyl substituted, for example:

In one embodiment, the compound of Formula I has the structure:

In one embodiment, the central pyrrolidine is modified by addition of a second heteroatom to a pyrrolidine ring, such as N, O, S, or Si, for example:

Another modification within the scope of the disclosure is joining a substituent on the central pyrrolidine ring to R⁷ or R⁸ to form a 5- to 6-membered heterocyclic ring, for example:

Example compounds having the modifications disclosed above include:

Central Core L-B Substituents

The central core L-B substituents in Formula I are illustrated below:

L is either (t), (u), or (v):

(t) is a group of the formula

where R¹⁷ is hydrogen or C₁-C₆alkyl and R¹⁸ and R^(18′) are independently chosen from hydrogen, halogen, hydroxymethyl, and methyl; and m is 0, 1, 2, or 3;

(u) is a bond,

(v) or a directly linked optionally substituted alkyl, alkyl(heteroaryl), heterocyclic aryl, heteroaryl, moiety including but not limited to:

B is a monocyclic, bicyclic carbocyclic or carbocyclic-oxy group or a monocyclic, bicyclic, or tricyclic heterocyclic group having 1, 2, 3, or 4 heteroatoms independently selected from N, O, and S and from 4 to 7 ring atoms per ring, or B is a C₂-C₆alkenyl or C₂-C₆alkynyl group, or B is —(C₀-C₄alkyl)(aryl), —(C₀-C₄alkyl)(heteroaryl), or —(C₀-C₄alkyl)(biphenyl).

Each of which B is unsubstituted or substituted with one or more substituents independently chosen from (w) and (x) and 0 or 1 substituents chosen from (y) and (z):

(w) halogen, hydroxyl, —COOH, cyano, C₁-C₆alkyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkylNR⁹R¹⁰, —SO₂R⁹, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy;

(x) nitro, C₂-C₆alkenyl, C₂-C₆alkynyl, C₁-C₆thioalkyl, -JC₃-C₇cycloalkyl, —B(OH)₂, -JC(O)NR⁹R²³, -JOSO₂OR²¹, —C(O)(CH₂)₁₋₄S(O)R²¹, SR⁹, —O(CH₂)₁₋₄S(O)NR²¹R²², -JOP(O)(OR²¹)(OR²²), -JP(O)(OR²¹)(OR₂₂), -JOP(O)(OR^(2′))R²², -JP(O)(OR²¹)R²², -JOP(O)R²¹R²², -JP(O)R²¹R²², -JSP(O)(OR²¹)(OR²²), -JSP(O)(OR²)(R²²), -JSP(O)(R²¹)(R²²), -JNR⁹P(O)(NHR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(OR²²), -JC(S)R²¹, -JNR²¹SO₂R²², -JNR⁹S(O)NR¹⁰R²², -JNR⁹SO₂NR¹⁰R²², -JSO₂NR⁹COR²², -JSO₂NR⁹CONR²¹R²², -JNR²¹SO₂R²², -JC(O)NR²¹SO₂R²², -JC(NH₂)NR²², -JC(NH₂)NR⁹S(O)₂R²², -JOC(O)NR²¹R²², -JNR²¹C(O)OR²², -JNR²¹OC(O)R²², —(CH₂)₁₋₄C(O)NR²¹R²², -JC(O)R²⁴R²⁵, -JNR⁹C(O)R²¹, -JC(O)R²¹, -JNR⁹C(O)NR¹⁰R²², —CCR²¹, —(CH₂)₁₋₄OC(O)R²¹, and -JC(O)OR²³; each of which (x) may be unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂, —P(O)(OH)₂, C₁-C₆alkyl, C₁-C₆alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₆alkylester, C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy;

(y) naphthyl, naphthyloxy, indanyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl containing 1 or 2 heteroatoms chosen from N, O, and S, and bicyclic heterocycle containing 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and containing 4- to 7-ring atoms in each ring; each of which (y) is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; and (z) tetrazolyl, (phenyl)C₀-C₂alkyl, (phenyl)C₁-C₂alkoxy, phenoxy, and 5- or 6-membered heteroaryl containing 1, 2, or 3 heteroatoms independently chosen from N, O, B, and S, each of which (z) is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, —OSi(CH₃)₂C(CH₃)₃, —Si(CH₃)₂C(CH₃)₃, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

In one embodiment, -L-B— is

where

R²⁶ and R²⁷ are independently chosen from hydrogen, halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, C₁-C₆thioalkyl, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C₀-C₄alkoxy(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, C₁-C₂haloalkoxy, and C₁-C₂haloalkylthio.

Non-Limiting L-B Embodiments

In another embodiment, -L-B— is

wherein

R¹⁸ and R^(18′) are independently chosen from hydrogen, halogen, hydroxymethyl, and methyl; and m is 0 or 1; and

R²⁶, R²⁷, and R²⁸ are independently chosen from hydrogen, halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, C₁-C₆thioalkyl, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl, (aryl)C₀-C₄alkyl-, (heteroaryl)C₀-C₄alkyl-, and —C₀-C₄alkoxy(C₃-C₇cycloalkyl); each of which R²⁶, R²⁷, and R²⁸ other than hydrogen, halogen, hydroxyl, nitro, cyano, is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, amino, C₁-C₂alkoxy, C₁-C₂haloalkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl-, and C₁-C₂haloalkoxy; and

R²⁹ is hydrogen, C₁-C₂alkyl, C₁C₂haloalkyl or —Si(CH₃)₂C(CH₃)₃.

In one embodiment, m is 0.

In one embodiment, the disclosure further includes compounds and salts of Formula I in which B is 2-fluoro-3-chlorophenyl. In another embodiment, another carbocyclic, aryl, heterocyclic, or heteroaryl group such as 2-bromo-pyridin-6-yl, 1-(2,2,2-trifluoroethyl)-1H-pyrazol-3-yl, 2,2-dichlorocyclopropylmethyl, or 2-fluoro-3-trimethylsilylphenyl is used.

In another embodiment, B is phenyl, pyridyl, or indanyl each of which is unsubstituted or substituted with one or more substituents independently chosen from hydrogen, halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, C₁-C₆thioalkyl, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl, —C₀-C₄alkoxy(C₃-C₇cycloalkyl), (phenyl)C₀-C₂alkyl, (pyridyl)C₀-C₂alkyl; each of which substituents other than hydrogen, halogen, hydroxyl, nitro, cyano, is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, amino, C₁-C₂alkyl, C₁-C₂alkoxy, —OSi(CH₃)₂C(CH₃)₃, —Si(CH₃)₂C(CH₃)₃, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

In another embodiment, B is phenyl or pyridyl substituted with 1, 2, or 3 substituents chosen from chloro, bromo, hydroxyl, —SCF₃, C₁-C₂alkyl, C₁-C₂alkoxy, trifluoromethyl, phenyl and trifluoromethoxy each of which substituents other than chloro, bromo, hydroxyl, —SCF₃, can be optionally substituted.

In certain embodiments, B is a 2-fluoro-3-chlorophenyl or a 2-fluoro-3-trifluoromethoxyphenyl group.

In one embodiment, B is pyridyl, optionally substituted with halogen, C₁-C₂alkoxy, and trifluoromethyl.

In one embodiment, B is phenyl, substituted with 1, 2, or 3 substituents independently selected from halogen, C₁-C₂alkyl, C₁-C₂alkoxy, trifluoromethyl, and optionally substituted phenyl.

In one embodiment, R²³ is independently chosen at each occurrence from (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S.

In one embodiment, B is selected from

where R²⁷ is hydrogen, methyl, or trifluoromethyl; R²⁸ is hydrogen or halogen; and R²⁹ is hydrogen, methyl, trifluoromethyl, or —Si(CH₃)₂C(CH₃)₃.

Central Core (C═O)A Substituent

The central core (C═O)A substituent in Formula I is illustrated below:

A is a group chosen from (k) and (l) where (k) is

and (l) is

X⁴ is B(OH) and Y is CHR⁹; or X⁴ is CHR⁹ and Y is B(OH).

R¹⁰¹ is hydrogen, alkyl, carboxy.

R⁴ is (m) or (n):

(m) —CHO, —CONH₂, or C₂-C₆alkanoyl, including C(O)C₃-C₇cycloalkyl;

(n) hydrogen, —SO₂NH₂, —C(CH₂)₂F, —CH(CF₃)NH₂, C₁-C₆alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C(O)C₀-C₂alkyl(C₃-C₇cycloalkyl),

each of which R⁴ other than hydrogen, —CHO, and —CONH₂, is unsubstituted or substituted with one or more of amino, imino, halogen, hydroxyl, cyano, cyanoimino, C₁-C₂alkyl, C₁-C₂alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

R⁵ and R⁶ are independently chosen from (o) and (p):

(o) —CHO, —C(O)NH₂, —C(O)NH(CH₃), or C₂-C₆alkanoyl;

(p) hydrogen, hydroxyl, halogen, cyano, nitro, —COOH, —SO₂NH₂, —C(NH₂)C₁-C₃alkyl, —C(NH₂)C₁-C₃haloalkyl, —CF(C═CH₂), —C(═NCN)C₁-C₆alkyl, C₁-C₆alkyl, C₂-C₆alkenyl, C₁-C₆alkoxy, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C(O)C₀-C₄alkyl(C₃-C₇cycloalkyl), —P(O)(OR⁹)₂, —OC(O)R⁹, —C(O)OR⁹, —C(O)N(CH₂CH₂R⁹)(R¹⁰), —NR⁹C(O)R¹⁰, phenyl, or 5- to 6-membered heteroaryl.

Each R⁵ and R⁶ other than hydrogen, hydroxyl, cyano, and —COOH is unsubstituted or optionally substituted. For example, R⁵ and R⁶ other than hydrogen, hydroxyl, cyano, and —COOH may be substituted with one or more substituents independently chosen from halogen, hydroxyl, amino, imino, cyano, cyanoimino, C₁-C₂alkyl, C₁-C₄alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₂haloalkyl, C₁-C₂haloalkoxy, C(O)alkyl, C(O)cycloalkyl, C(O)aryl, C(O)heterocycle, and C(O)heteroaryl.

R^(6′) is hydrogen, halogen, hydroxyl, C₁-C₄alkyl, or C₁-C₄alkoxy; or R⁶ and R^(6′) may be taken together to form an oxo, vinyl, or imino group.

R⁷ is hydrogen, C₁-C₆alkyl, or —C₀-C₄alkyl(C₃-C₇cycloalkyl).

R⁸ and R^(8′) are independently chosen from hydrogen, halogen, hydroxyl, C₁-C₆alkyl, C₁-C₆alkoxy, and (C₁-C₄alkylamino)C₀-C₂alkyl, or R⁸ and R^(8′) are taken together to form an oxo group, or can be taken together with the carbon that they are bonded to form a 3-membered carbocyclic ring.

R¹⁶ is 0 or 1 or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

R¹⁹ is hydrogen, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, —SO₂C₁-C₆alkyl, (mono- and di-C₁-C₆alkylamino)C₁-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C₀-C₄alkyl(C₃-C₇heterocycloalkyl), —C₀-C₄alkyl(aryl), C₀-C₄alkyl(heteroaryl), each of which R¹⁹ other than hydrogen is substituted with 0 or 1 or more substituents independently chosen from halogen, hydroxyl, amino, —COOH, and —C(O)OC₁-C₄alkyl.

X¹¹ is N or CR¹¹.

X¹² is N or CR¹².

X¹³ is N or CR¹³.

X¹⁴ is N or CR¹⁴.

No more than 2 of X¹, X¹², X¹³, and X¹⁴ are N.

R¹¹, R¹⁴, and R¹⁵ are independently chosen at each occurrence from hydrogen, halogen, hydroxyl, nitro, cyano, —NR⁹C(O)R¹⁰, C(O)NR⁹R¹⁰, —O(PO)(OR⁹)₂, —(PO)(OR⁹)₂, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkenyl(aryl), C₂-C₆alkenyl(cycloalkyl), C₂-C₆alkenyl(heterocycle), C₂-C₆alkenyl(heteroaryl), C₂-C₆alkynyl, C₂-C₆alkynyl(aryl), C₂-C₆alkynyl(cycloalkyl), C₂-C₆alkynyl(heterocycle), C₂-C₆alkynyl(heteroaryl), C₂-C₆alkanoyl, C₁-C₆alkoxy, C₁-C₆thioalkyl, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl), (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S), —C₀-C₄alkoxy(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy. Alternatively, R¹³ and R¹⁴ can together form a bridge that can be an optionally substituted cycloalkyl, heterocycle or heteroaryl ring.

In one embodiment, R⁵ and R⁶ are independently chosen from —CHO, —C(O)NH₂, —C(O)NH(CH₃), C₂-C₆alkanoyl, and hydrogen.

In one embodiment, each R⁵ and R⁶ other than hydrogen, hydroxyl, cyano, and —COOH is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, amino, imino, cyano, cyanoimino, C₁-C₂alkyl, C₁-C₄alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₂haloalkyl, C₁-C₂haloalkoxy, C(O)alkyl, C(O)cycloalkyl, C(O)aryl, C(O)heterocycle, and C(O)heteroaryl.

In one embodiment, R⁸ and R^(8′) are independently hydrogen or methyl.

In one embodiment, R⁸ and R^(8′) are hydrogen.

In one embodiment, R⁷ is hydrogen or methyl.

In one embodiment, R⁷ is hydrogen.

In an alternate embodiment, two A groups can be bonded together to form a dimer through a suitable linking group that achieves the desired purpose. Examples of linking groups include but are not limited to, urea, amide, —C(O)—C(O)—, carbamate and ketone. In one embodiment, two heteroaryl rings, for example, two indole rings, are linked through a urea to form indole-NHC(O)NH-indole.

Embodiments of Formulas IA, IB, IC, and ID

To further illustrate the invention, various embodiments of Formula IA, IB, IC and ID are provided. These are presented by way of example to show some of the variations among presented compounds within the invention and can be applied to any of the Formulas I-XXX.

In one aspect, this disclosure includes compounds and salts of Formula IA:

where R⁶, R¹³, and B may carry any of the definitions set forth herein for this variable.

In another aspect, this disclosure includes compounds and salts of Formula IB, IC, and ID.

In Formulas IA, IB, IC, and ID, the variables may include any of the definitions set forth herein that results in a stable compound.

Embodiments of Formula VII

To further illustrate the invention, various embodiments of Formula VII. In one aspect, the disclosure includes compounds and salts of Formula VII:

wherein:

R¹, R², R^(2′), and R³ are independently chosen from hydrogen, halogen, C₁-C₄alkyl, C₁-C₄alkoxy, —C₀-C₂alkylNR⁹R¹⁰, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —O—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy;

R⁸ and R^(8′) are independently chosen from hydrogen, halogen, and methyl;

R⁵ is hydrogen, hydroxyl, cyano, —COOH, C₁-C₆alkyl, C₁-C₆alkoxy, C₂-C₆alkanoyl —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C(O)C₀-C₄alkyl(C₃-C₇cycloalkyl, C₁-C₂haloalkyl, or C₁-C₂haloalkoxy;

R⁶ is —C(O)CH₃, —C(O)NH₂, —C(O)CF₃, —C(O)(cyclopropyl), or -ethyl(cyanoimino); and

R¹¹ and R¹⁴ are independently chosen from hydrogen, halogen, hydroxyl, amino, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, C₁-C₆thioalkyl, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl), —OC₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.

Prodrugs of Formula I are also within the scope of the disclosure.

III. Pharmaceutical Preparations

Compounds disclosed herein can be administered as the neat chemical, but can also administered as a pharmaceutical composition, that includes an effective amount for a host in need of treatment of the selected compound of Formula I, as described herein. Accordingly, the disclosure provides pharmaceutical compositions comprising an effective amount of compound or pharmaceutically acceptable salt of Formula I, together with at least one pharmaceutically acceptable carrier. The pharmaceutical composition may contain a compound or salt of Formula I as the only active agent, or, in an alternative embodiment, Formula I and at least one additional active agent. In certain embodiments the pharmaceutical composition is in a dosage form that contains from about 0.1 mg to about 2000 mg, from about 10 mg to about 1000 mg, from about 100 mg to about 800 mg, or from about 200 mg to about 600 mg of a compound of Formula I and optionally from about 0.1 mg to about 2000 mg, from about 10 mg to about 1000 mg, from about 100 mg to about 800 mg, or from about 200 mg to about 600 mg of an additional active agent in a unit dosage form. Examples are dosage forms with at least 25, 50, 100, 200, 250, 300, 400, 500, 600, 700, or 750 mg of active compound, or its salt. The pharmaceutical composition may also include a molar ratio of a compound of Formula I and an additional active agent. For example the pharmaceutical composition may contain a molar ratio of about 0.5:1, about 1:1, about 2:1, about 3:1 or from about 1.5:1 to about 4:1 of an another anti-inflammatory agent.

Compounds disclosed herein may be administered orally, topically, parenterally, by inhalation or spray, sublingually, via implant, including ocular implant, transdermally, via buccal administration, rectally, as an ophthalmic solution, injection, including ocular injection, intraveneous, intra-aortal, intracranial, or by other means, in dosage unit formulations containing conventional pharmaceutically acceptable carriers. The pharmaceutical composition may be formulated as any pharmaceutically useful form, e.g., as an aerosol, a cream, a gel, a pill, a capsule, a tablet, a syrup, a transdermal patch, or an ophthalmic solution. Some dosage forms, such as tablets and capsules, are subdivided into suitably sized unit doses containing appropriate quantities of the active components, e.g., an effective amount to achieve the desired purpose.

Carriers include excipients and diluents and must be of sufficiently high purity and sufficiently low toxicity to render them suitable for administration to the patient being treated. The carrier can be inert or it can possess pharmaceutical benefits of its own. The amount of carrier employed in conjunction with the compound is sufficient to provide a practical quantity of material for administration per unit dose of the compound.

Classes of carriers include, but are not limited to binders, buffering agents, coloring agents, diluents, disintegrants, emulsifiers, flavorants, glidents, lubricants, preservatives, stabilizers, surfactants, tableting agents, and wetting agents. Some carriers may be listed in more than one class, for example vegetable oil may be used as a lubricant in some formulations and a diluent in others. Exemplary pharmaceutically acceptable carriers include sugars, starches, celluloses, powdered tragacanth, malt, gelatin; talc, and vegetable oils. Optional active agents may be included in a pharmaceutical composition, which do not substantially interfere with the activity of the compound of the present invention.

The pharmaceutical compositions/combinations can be formulated for oral administration. These compositions can contain any amount of active compound for Formula I that achieves the desired result, for example between 0.1 and 99 weight % (wt. %) of a compound of Formula I and usually at least about 5 wt. % of a compound of Formula I. Some embodiments contain from about 25 wt. % to about 50 wt. % or from about 5 wt. % to about 75 wt. % of the compound of Formula I.

The complement factor D inhibitors of the present invention can be administered, for example, either systemically or locally. Systemic administration includes, for example, oral, transdermal, subdermal, intraperitioneal, subcutaneous, transnasal, sublingual, or rectal. Local administration for ocular administration includes: topical, intravitreal, periocular, transscleral, retrobulbar, juxtascleral, sub-tenon, or via an intraocular device. The inhibitors may be delivered via a sustained delivery device implanted intravitreally or transsclerally, or by other known means of local ocular delivery.

IV. Methods of Treatment

The compounds and pharmaceutical compositions disclosed herein are useful for treating or preventing a disorder that is mediated by the complement pathway, and in particular, a pathway that is modulated by complement factor D. In certain embodiments, the disorder is an inflammatory disorder, an immune disorder, an autoimmune disorder, or complement factor D related disorders in a host. In one embodiment, the disorder is an ocular disorder. Complement mediated disorders that may be treated or prevented by the compounds and compositions of this disclosure include, but are not limited to, inflammatory effects of sepsis, systemic inflammatory response syndrome (SIRS), ischemia/reperfusion injury (I/R injury), psoriasis, myasthenia gravis, system lupus erythematosus (SLE), paroxysmal nocturnal hemoglobinuria (PNH), hereditary angioedema, multiple sclerosis, trauma, burn injury, capillary leak syndrome, obesity, diabetes, Alzheimer's dementia, stroke, schizophrenia, epilepsy, age-related macular degeneration, glaucoma, diabetic retinopathy, asthma, allergy, acute respiratory distress syndrome (ARDS), atypical hemolytic uremic syndrome (aHUS), hemolytic uremic syndrome (HUS), cystic fibrosis, myocardial infarction, lupus nephritides, Crohn's disease, rheumatoid arthritis, atherosclerosis, transplant rejection, prevention of fetal loss, biomaterial reactions (e.g. in hemodialysis, inplants), C3 glomerulonephritis, abdominal aortic aneurysm, neuromyelitis optica (NMO), vasculitis, neurological disorders, Guillain Barre Syndrome, traumatic brain injury, Parkinson's disease, disorders of inappropriate or undesirable complement activation, hemodialysis complications, hyperacute allograft rejection, xenograft rejection, interleukin-2 induced toxicity during I L-2 therapy, inflammatory disorders, inflammation of autoimmune diseases, adult respiratory distress syndrome, thermal injury including burns or frostbite, myocarditis, post-ischemic reperfusion conditions, balloon angioplasty, post-pump syndrome in cardiopulmonary bypass or renal bypass, hemodialysis, renal ischemia, mesenteric artery reperfusion after aortic reconstruction, immune complex disorders and autoimmune diseases, SLE nephritis, proliferative nephritis, liver fibrosis, hemolytic anemia, tissue regeneration and neural regeneration. In addition, other known complement related disease are lung disease and disorders such as dyspnea, hemoptysis, chronic obstructive pulmonary disease (COPD), emphysema, pulmonary embolisms and infarcts, pneumonia, fibrogenic dust diseases, inert dusts and minerals (e.g., silicon, coal dust, beryllium, and asbestos), pulmonary fibrosis, organic dust diseases, chemical injury (due to irritant gases and chemicals, e.g., chlorine, phosgene, sulfur dioxide, hydrogen sulfide, nitrogen dioxide, ammonia, and hydrochloric acid), smoke injury, thermal injury (e.g., burn, freeze), bronchoconstriction, hypersensitivity pneumonitis, parasitic diseases, Goodpasture's Syndrome, pulmonary vasculitis, Pauci-immune vasculitis, immune complex-associated inflammation, uveitis (including Behcet's disease and other sub-types of uveitis), antiphospholipid syndrome, arthritis, autoimmune heart disease, inflammatory bowel disease, ischemia-reperfusion injuries, Barraquer-Simons Syndrome, hemodialysis, systemic lupus, lupus erythematosus, transplantation, diseases of the central nervous system and other neurodegenerative conditions, glomerulonephritis (including membrane proliferative glomerulonephritis), blistering cutaneous diseases (including bullous pemphigoid, pemphigus, and epidermolysis bullosa), ocular cicatrical pemphigoid, MPGN II, uveitis, adult macular degeneration, diabetic retinopathy, retinitis pigmentosa, macular edema, Behcet's uveitis, multifocal choroiditis, Vogt-Koyangi-Harada syndrome, imtermediate uveitis, birdshot retino-chorioditis, sympathetic ophthalmia, ocular dicatricial pemphigoid, ocular pemphigus, nonartertic ischemic optic neuropathy, postoperative inflammation, and retinal vein occlusion.

In some embodiments, complement mediated diseases include ophthalmic diseases (including early or neovascular age-related macular degeneration and geographic atrophy), autoimmune diseases (including arthritis, rheumatoid arthritis), respiratory diseases, cardiovascular diseases. In other embodiments, the compounds of the invention are suitable for use in the treatment of diseases and disorders associated with fatty acid metabolism, including obesity and other metabolic disorders.

In one embodiment, a method for the treatment of paroxysmal nocturnal hemoglobinuria (PNH) is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier. In another embodiment, a method for the treatment of age-related macular degeneration (AMD) is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier. In another embodiment, a method for the treatment of rheumatoid arthritis is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier. In another embodiment, a method for the treatment of multiple sclerosis is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier. In another embodiment, a method for the treatment of myasthenia gravis is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier. In another embodiment, a method for the treatment of atypical hemolytic uremic syndrome (aHUS) is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier. In another embodiment, a method for the treatment of C3 glomerulonephritis is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier. In another embodiment, a method for the treatment of abdominal aortic aneurysm is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier. In another embodiment, a method for the treatment of neuromyelitis optica (NMO) is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier.

In some embodiments, the present invention provides methods of treating or preventing an inflammatory disorder or a complement related disease, by administering to a host in need thereof an effective amount of a compound of Formula I of the invention. In some embodiments, the present invention provides methods of treating or preventing an inflammatory disorder more generally, an immune disorder, autoimmune disorder, or complement factor D related disease, by providing an effective amount of a compound or pharmaceutically acceptable salt of Formula I to patient with a factor D mediated inflammatory disorder. A compound or salt of Formula I may be provided as the only active agent or may be provided together with one or more additional active agents.

In one embodiment, a method for the treatment of a disorder associated with a dysfunction in the complement cascade is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier. In one embodiment, a method of inhibiting activation of the alternative complement pathway in a subject is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier. In one embodiment, a method of modulating factor D activity in a subject is provided that includes the administration of an effective amount of a compound of Formula I, or a pharmaceutically acceptable salt thereof, optionally in a pharmaceutically acceptable carrier.

“Prevention” as used in this disclosure means decreasing the likelihood of the appearance of symptoms in a patient administered the compound prophylactically as compared to the likelihood of the appearance of symptoms in patients not administered the compound or decreasing the severity of symptoms in a patient administered the compound prophylactically as compared to the severity of symptoms experienced by patients with the disorder or condition who were not administered the compound. In an alternative embodiment, an effective amount of a compound of Formula I is used to prevent or prophylaxis of a complement factor D related disorder.

An effective amount of a pharmaceutical composition/combination of the invention may be an amount sufficient to (a) inhibit the progression of a disorder mediated by the complement pathway, including an inflammatory, immune, including an autoimmune, disorder or complement factor D related disease; (b) cause a regression of an inflammatory, immune, including an autoimmune, disorder or complement factor D related disease; or (c) cause a cure of an inflammatory, immune, including an autoimmune, disorder or complement factor D related disease.

An effective amount of a compound or pharmaceutical composition described herein will also provide a sufficient amount of the active agent when administered to a patient to provide a clinical benefit. Such an amount may be ascertained experimentally, for example by assaying blood concentration of the agent, or theoretically, by calculating bioavailability.

V. Combination Therapy

In one embodiment, a compound or salt of Formula I may be provided in combination or alternation with at least one additional inhibitor of the complement system or a second active compound with a different biological mechanism of action. In one embodiment, a compound or salt of Formula I may be provided in combination with a complement C5 inhibitor or C5 convertase inhibitor. In another embodiment, a compound or salt of Formula I may be provided in combination with eculizumab. In one embodiment, a compound or salt of Formula I may be provided in combination with additional inhibitors of factor D.

In one embodiment, a compound or salt of Formula I may be provided together with a compound that inhibits an enzyme that metabolizes protease inhibitors. In one embodiment, a compound or salt of Formula I may be provided together with ritonavir.

In nonlimiting embodiments, a compound or salt of Formula I may be provided together with a protease inhibitor, a soluble complement regulator, a therapeutic antibody (monoclonal or polyclonal), complement component inhibitors, receptor agonists, or siRNAs.

Nonlimiting examples of active agents in these categories are:

Protease inhibitors: plasma-derived C1-INH concentrates, for example Cetor® (Sanquin), Berinert-P® (CSL Behring, Lev Pharma), and Cinryze®; and recombinant human C1-inhibitors, for example Rhucin®;

Soluble complement regulators: Soluble complement receptor 1 (TP10) (Avant Immunotherapeutics); sCR1-sLeX/TP-20 (Avant Immunotherapeutics); MLN-2222/CAB-2 (Millenium Pharmaceuticals); Mirococept (Inflazyme Pharmaceuticals);

Therapeutic antibodies: Eculizumab/Soliris (Alexion Pharmaceuticals); Pexelizumab (Alexion Pharmaceuticals); Ofatumumab (Genmab A/S); TNX-234 (Tanox); TNX-558 (Tanox); TA106 (Taligen Therapeutics); Neutrazumab (G2 Therapies); Anti-properdin (Novelmed Therapeutics); HuMax-CD38 (Genmab A/S);

Complement component inhibitors: Compstatin/POT-4 (Potentia Pharmaceuticals); ARC1905 (Archemix);

Receptor agonists: PMX-53 (Peptech Ltd.); JPE-137 (Jerini); JSM-7717 (Jerini);

Others: Recombinant human MBL (rhMBL; Enzon Pharmaceuticals).

In an embodiment, the present invention provides a method of treating or preventing age-related macular degeneration (AMD) by administering to a subject in need thereof an effective amount of a composition comprising a compound of the current invention. In one embodiment, the compositions of the present invention are administered in combination with an anti-VEGF agent. Nonlimiting examples of anti-VEGF agents include, but are not limited to, aflibercept (Eylea®; Regeneron Pharmaceuticals); ranibizumab (Lucentis®: Genentech and Novartis); and pegaptanib (Macugen®; OSI Pharmaceuticals and Pfizer); Bevacizumab (Avastin; Genentech/Roche); anecortane acetate, squalamine lactate, and corticosteroids, including, but not limited to, triamcinolone acetonide.

In another embodiment, a compound of Formula I can be combined with a second agent in order to treat a disorder of the eye.

Examples of types of therapeutic agents that can be used in combination for ocular applications include anti-inflammatory drugs, antimicrobial agents, anti-angiogenesis agents, immunosuppressants, antibodies, steroids, ocular antihypertensive drugs and combinations thereof. Examples of therapeutic agents include amikacin, anecortane acetate, anthracenedione, anthracycline, an azole, amphotericin B, bevacizumab, camptothecin, cefuroxime, chloramphenicol, chlorhexidine, chlorhexidine digluconate, clortrimazole, a clotrimazole cephalosporin, corticosteroids, dexamethasone, desamethazone, econazole, eftazidime, epipodophyllotoxin, fluconazole, flucytosine, fluoropyrimidines, fluoroquinolines, gatifloxacin, glycopeptides, imidazoles, itraconazole, ivermectin, ketoconazole, levofloxacin, macrolides, miconazole, miconazole nitrate, moxifloxacin, natamycin, neomycin, nystatin, ofloxacin, polyhexamethylene biguanide, prednisolone, prednisolone acetate, pegaptanib, platinum analogues, polymicin B, propamidine isethionate, pyrimidine nucleoside, ranibizumab, squalamine lactate, sulfonamides, triamcinolone, triamcinolone acetonide, triazoles, vancomycin, anti-vascular endothelial growth factor (VEGF) agents, VEGF antibodies, VEGF antibody fragments, vinca alkaloid, timolol, betaxolol, travoprost, latanoprost, bimatoprost, brimonidine, dorzolamide, acetazolamide, pilocarpine, ciprofloxacin, azithromycin, gentamycin, tobramycin, cefazolin, voriconazole, gancyclovir, cidofovir, foscarnet, diclofenac, nepafenac, ketorolac, ibuprofen, indomethacin, fluoromethalone, rimexolone, anecortave, cyclosporine, methotrexate, tacrolimus and combinations thereof. Examples of eye disorders that may be treated according to the compositions and methods disclosed herein include amoebic keratitis, fungal keratitis, bacterial keratitis, viral keratitis, onchorcercal keratitis, bacterial keratoconjunctivitis, viral keratoconjunctivitis, corneal dystrophic diseases, Fuchs' endothelial dystrophy, Sjogren's syndrome, Stevens-Johnson syndrome, autoimmune dry eye diseases, environmental dry eye diseases, corneal neovascularization diseases, post-corneal transplant rejection prophylaxis and treatment, autoimmune uveitis, infectious uveitis, anterior uveitis, posterior uveitis (including toxoplasmosis), pan-uveitis, an inflammatory disease of the vitreous or retina, endophthalmitis prophylaxis and treatment, macular edema, macular degeneration, age related macular degeneration, proliferative and non-proliferative diabetic retinopathy, hypertensive retinopathy, an autoimmune disease of the retina, primary and metastatic intraocular melanoma, other intraocular metastatic tumors, open angle glaucoma, closed angle glaucoma, pigmentary glaucoma and combinations thereof.

A compound of Formula I, or a combination of Formula I and another active agent, can be administered into an eye compartment of via injection into the vitreous chamber, subretinal space, subchoroidal space, the episclera, the conjunctiva, the sclera, the anterior chamber, and the cornea and compartments therein (e.g., subepithelial, intrastromal, endothelial).

In an alternative embodiment, a compound of Formula I, or a combination of Formula I and another active agent, can be administered into an eye compartment via binding to a mucosal penetrating particle to treat a condition located in the vitreous chamber, subretinal space, subchoroidal space, the episclera, the conjunctiva, the sclera or the anterior chamber, and the cornea and compartments therein (e.g., subepithelial, intrastromal, endothelial). Mucosal penetrating particles are known in the art, and are described in, for example, PCT published application WO 2013166436 to Kala Pharmaceuticals, incorporated in its entirety herein.

In other embodiments, a composition comprising compound of Formula I suitable for topical administration to an eye is provided. The pharmaceutical composition comprises a plurality of coated particles, comprising a core particle comprising a compound of Formula I, wherein Formula I constitutes at least about 80 wt % of the core particle, and a coating comprising one or more surface-altering agents, wherein the one or more surface-altering agents comprise at least one of a poloxamer, a poly(vinyl alcohol), or a polysorbate. The one or more surface-altering agents is present on the outer surface of the core particle at a density of at least 0.01 molecules/nm. The one or more surface-altering agents is present in the pharmaceutical composition in an amount of between about 0.001% to about 5% by weight. The plurality of coated particles have an average smallest cross-sectional dimension of less than about 1 micron. The pharmaceutical composition also includes one or more ophthalmically acceptable carriers, additives, and/or diluents.

It will be appreciated by one of ordinary skill in the art that particles suitable for use with the presently disclosed methods can exist in a variety of shapes, including, but not limited to, spheroids, rods, disks, pyramids, cubes, cylinders, nanohelixes, nanosprings, nanorings, rod-shaped particles, arrow-shaped particles, teardrop-shaped particles, tetrapod-shaped particles, prism-shaped particles, and a plurality of other geometric and non-geometric shapes. In some embodiments, the presently disclosed particles have a spherical shape.

In one embodiment, the present invention provides a method of treating or preventing paroxysmal nocturnal hemoglobinuria (PNH) by administering to a subject in need thereof an effective amount of a composition comprising a compound of the current invention. In one embodiment, the present invention provides a method of treating or preventing paroxysmal nocturnal hemoglobinuria (PNH) by administering to a subject in need thereof an effective amount of a composition comprising a compound of the current invention in combination or alternation with additional inhibitors of the complement system or another active compound with a different biological mechanism of action. In another embodiment, the present invention provides a method of treating or preventing paroxysmal nocturnal hemoglobinuria (PNH) by administering to a subject in need thereof an effective amount of a composition comprising a compound of the current invention in combination or alternation with eculizumab.

In one embodiment, the present invention provides a method of treating or preventing rheumatoid arthritis by administering to a subject in need thereof an effective amount of a composition comprising a compound of the current invention. In one embodiment, the present invention provides a method of treating or preventing rheumatoid arthritis by administering to a subject in need thereof an effective amount of a composition comprising a compound of the current invention in combination or alternation with an additional inhibitor of the complement system. In another embodiment, the present invention provides a method of treating or preventing rheumatoid arthritis by administering to a subject in need thereof an effective amount of a composition comprising a compound of the current invention in combination or alternation with methotrexate.

In certain embodiments, a compound of Formula I is administered in combination or alternation with at least one anti-rhuematoid arthritis drug selected from: salicylates including aspirin (Anacin, Ascriptin, Bayer Aspirin, Ecotrin) and salsalate (Mono-Gesic, Salgesic); nonsteroidal anti-inflammatory drugs (NSAIDs); nonselective inhibitors of the cyclo-oxygenase (COX-1 and COX-2) enzymes, including diclofenac (Cataflam, Voltaren), ibuprofen (Advil, Motrin), ketoprofen (Orudis), naproxen (Aleve, Naprosyn), piroxicam (Feldene), etodolac (Lodine), indomethacin, oxaprozin (Daypro), nabumetone (Relafen), and meloxicam (Mobic); selective cyclo-oxygenase-2 (COX-2) inhibitors including Celecoxib (Celebrex); disease-modifying antirheumatic drugs (DMARDs), including azathioprine (Imuran), cyclosporine (Sandimmune, Neoral), gold salts (Ridaura, Solganal, Aurolate, Myochrysine), hydroxychloroquine (Plaquenil), leflunomide (Arava), methotrexate (Rheumatrex), penicillamine (Cuprimine), and sulfasalazine (Azulfidine); biologic drugs including abatacept (Orencia), etanercept (Enbrel), infliximab (Remicade), adalimumab (Humira), and anakinra (Kineret); corticosteroids including betamethasone (Celestone Soluspan), cortisone (Cortone), dexamethasone (Decadron), methylprednisolone (SoluMedrol, DepoMedrol), prednisolone (Delta-Cortef), prednisone (Deltasone, Orasone), and triamcinolone (Aristocort); gold salts, including Auranofin (Ridaura); Aurothioglucose (Solganal); Aurolate; Myochrysine; or any combination thereof.

In one embodiment, the present invention provides a method of treating or preventing multiple sclerosis by administering to a subject in need thereof an effective amount of a composition comprising a compound of the current invention. In one embodiment, the present invention provides a method of treating or preventing multiple sclerosis by administering to a subject in need thereof an effective amount of a composition comprising a compound of the current invention in combination or alternation with additional inhibitors of the complement system. In another embodiment, the present invention provides a method of treating or preventing multiple sclerosis by administering to a subject in need thereof an effective amount of a composition comprising a compound of the current invention in combination or alternation with a corticosteroid. Examples of corticosteroids include, but are not limited to, prednisone, dexamethasone, solumedrol, and methylprednisolone.

In one embodiment, a compound of Formula I is combined with at least one anti-multiple sclerosis drug selected from: Aubagio (teriflunomide), Avonex (interferon beta-1a), Betaseron (interferon beta-1b), Copaxone (glatiramer acetate), Extavia (interferon beta-1b), Gilenya (fingolimod), Lemtrada (alemtuzumab), Novantrone (mitoxantrone), Plegridy (peginterferon beta-1a), Rebif (interferon beta-1a), Tecfidera (dimethyl fumarate), Tysabri (natalizumab), Solu-Medrol (methylpredni solone), High-dose oral Deltasone (prednisone), H.P. Acthar Gel (ACTH), and combinations thereof.

In one aspect, a compound or salt of Formula I may be provided in combination or alternation with an immunosuppressive agent or an anti-inflammatory agent.

In one embodiment of the present invention, a compound described herein can be administered in combination or alternation with at least one immunosuppressive agent. The immunosuppressive agent as nonlimiting examples, may be a calcineurin inhibitor, e.g. a cyclosporin or an ascomycin, e.g. Cyclosporin A (NEORAL®), FK506 (tacrolimus), pimecrolimus, a mTOR inhibitor, e.g. rapamycin or a derivative thereof, e.g. Sirolimus (RAPAMUNE®), Everolimus (Certican®), temsirolimus, zotarolimus, biolimus-7, biolimus-9, a rapalog, e.g. ridaforolimus, azathioprine, campath 1H, a S1P receptor modulator, e.g. fingolimod or an analogue thereof, an anti IL-8 antibody, mycophenolic acid or a salt thereof, e.g. sodium salt, or a prodrug thereof, e.g. Mycophenolate Mofetil (CELLCEPT®), OKT3 (ORTHOCLONE OKT3®), Prednisone, ATGAM®, THYMOGLOBULIN®, Brequinar Sodium, OKT4, T10B9.A-3A, 33B3.1, 15-deoxyspergualin, tresperimus, Leflunomide ARAVA®, CTLAI-Ig, anti-CD25, anti-IL2R, Basiliximab (SIMULECT®), Daclizumab (ZENAPAX®), mizorbine, methotrexate, dexamethasone, ISAtx-247, SDZ ASM 981 (pimecrolimus, Elidel®), CTLA41g (Abatacept), belatacept, LFA31g, etanercept (sold as Enbrel® by Immunex), adalimumab (Humira®), infliximab (Remicade®), an anti-LFA-1 antibody, natalizumab (Antegren®), Enlimomab, gavilimomab, antithymocyte immunoglobulin, siplizumab, Alefacept efalizumab, pentasa, mesalazine, asacol, codeine phosphate, benorylate, fenbufen, naprosyn, diclofenac, etodolac and indomethacin, aspirin and ibuprofen.

Examples of anti-inflammatory agents include methotrexate, dexamethasone, dexamethasone alcohol, dexamethasone sodium phosphate, fluromethalone acetate, fluromethalone alcohol, lotoprendol etabonate, medrysone, prednisolone acetate, prednisolone sodium phosphate, difluprednate, rimexolone, hydrocortisone, hydrocortisone acetate, lodoxamide tromethamine, aspirin, ibuprofen, suprofen, piroxicam, meloxicam, flubiprofen, naproxan, ketoprofen, tenoxicam, diclofenac sodium, ketotifen fumarate, diclofenac sodium, nepafenac, bromfenac, flurbiprofen sodium, suprofen, celecoxib, naproxen, rofecoxib, glucocorticoids, diclofenac, and any combination thereof. In one embodiment, a compound of Formula I is combined with one or more non-steroidal anti-inflammatory drugs (NSAIDs) selected from naproxen sodium (Anaprox), celecoxib (Celebrex), sulindac (Clinoril), oxaprozin (Daypro), salsalate (Disalcid), diflunisal (Dolobid), piroxicam (Feldene), indomethacin (Indocin), etodolac (Lodine), meloxicam (Mobic), naproxen (Naprosyn), nabumetone (Relafen), ketorolac tromethamine (Toradol), naproxen/esomeprazole (Vimovo), and diclofenac (Voltaren), and combinations thereof.

VI. Process of Preparation of Compounds of Formula I Abbreviations

-   (Boc)₂O di-tert-butyl dicarbonate -   ACN Acetonitrile -   AcOEt, EtOAc ethyl acetate -   CH₃OH, MeOH Methanol -   CsF Cesium fluoride -   CuI Cuprous iodide -   DCM, CH₂C₁₂ Dichloromethane -   DIEA, DIPEA N,N-diisopropylethylamine -   DMA N,N-dimethylacetamide -   DMF N,N-dimethylformamide -   DMSO Dimethyl sulfoxide -   DPPA Diphenyl phosphoryl azide -   Et₃N, TEA Triethylamine -   EtOAc Ethyl acetate -   EtOH Ethanol -   HATU 1-[Bis(dimethylamino)methylene]-1H-1,2,3-triazolo     [4,5-b]pyridinium 3-oxide hexafluorophosphate -   HCl Hydrochloric acid -   ^(i)Pr₂NEt N,N-diisopropylethylamine -   K₂CO₃ Potassium carbonate -   LiOH Lithium hydroxide -   MTBE Methyl ^(t)butylether -   Na₂SO₄ Sodium sulfate -   NaCl Sodium chloride -   NaH Sodium hydride -   NaHCO₃ Sodium bicarbonate -   NEt₃, TEA Triethylamine -   Pd(OAc)₂ Palladium acetate -   Pd(dppf)Cl₂ [1,1′-Bis(diphenylphosphino)     ferrocene]dichloropalladium(II) -   Pd(PPh₃)₂Cl₂ Bis(triphenylphosphine)palladium(II) dichloride -   Pd(PPh₃)₄ Tetrakis(triphenylphosphine)palladium(0) -   Pd₂(dba)₃ Tris(dibenzylideneacetone)dipalladium(0) -   PPh₃ Triphenylphosphine -   RT Room temperature -   TBTU O-Benzotriazolyl tetramethylisouronium tetrafluoroborate -   tBuOK potassium tert-butoxide -   Tf₂O trifluoromethanesulfonic anhydride -   TFA Trifluoroacetic acid -   THF Tetrahydrofuran -   TMSBr Bromotrimethylsilane -   t_(R) Retention time -   Zn(CN)₂ Zinc cyanide

General Methods

All nonaqueous reactions were performed under an atmosphere of dry argon or nitrogen gas using anhydrous solvents. The progress of reactions and the purity of target compounds were determined using one of the two liquid chromatography (LC) methods listed below. The structure of starting materials, intermediates, and final products was confirmed by standard analytical techniques, including NMR spectroscopy and mass spectrometry.

LC Method A

Instrument: Waters Acquity Ultra Performance LC

Column: ACQUITY UPLC BEH C18 2.1×50 mm, 1.7 μm

Column Temperature: 40° C.

Mobile Phase: Solvent A: H₂O+0.05% FA; Solvent B: CH₃CN+0.05% FA

Flow Rate: 0.8 mL/min

Gradient: 0.24 min @ 15% B, 3.26 min gradient (15-85% B), then 0.5 min @ 85% B.

Detection: UV (PDA), ELS, and MS (SQ in EI mode)

LC Method B

Instrument: Shimadzu LC-2010A HT

Column: Athena, C18-WP, 50×4.6 mm, 5 μm

Column Temperature: 40° C.

Mobile Phase: Solvent A: H₂O/CH₃OH/FA=90/10/0.1; Solvent B: H₂O/CH₃OH/FA=10/90/0.1

Flow Rate: 3 mL/min

Gradient: 0.4 min @ 30% B, 3.4 min gradient (30-100% B), then 0.8 min @ 100% B

Detection: UV (220/254 nm)

Example 1 General Route of Synthesis

A compound of the present invention can be prepared, for example, from a central core. In one embodiment, for example, the central core Structure 1 is an N-protected aminoacid where X¹ is nitrogen and PG=protecting group. In one embodiment, the central core is coupled to an amine to generate an amide of Structure 2 (wherein L-B includes a C(O)N moiety). Structure 2 can then be deprotected to generate Structure 3. Structure 3 is coupled to Structure 4 (A-COOH) to generate a second amide bond, forming a compound within Formula I. The chemistry is illustrated in Route 1.

Route 1

In an alternative embodiment, central core Structure 5 is reacted with a heterocyclic or heteroaryl compound to generate a compound of Structure 6. In one embodiment, Structure 6 is deprotected to generate a carboxylic acid, Structure 7. In one embodiment, Structure 7 is coupled to an amine to generate a compound of Formula I. This chemistry is illustrated in Route 2.

Route 2

In an alternative embodiment, Structure 8 is deprotected to generate an amine which is Structure 9. Structure 9 is then coupled to generate an amide which is Structure 6. Structure 6 is then deprotected to generate a carboxylic acid which is Structure 7. Structure 7 is then coupled to form the amide which falls within Formula I. The chemistry is illustrated in Route 3.

Route 3

In an alternate embodiment, a heteroaryl or aryl moiety, 4-1, is coupled to a central core to generate 4-2. The protected acid, 4-2 is deblocked to form the carboxylic acid, 4-3. The carboxylic acid is then coupled to form an amide (L-B) which is 4-4. The heteroaryl or aryl moiety, A′, can then be further derivitized to add substituents at the X¹¹, X¹², X¹³ and X¹⁴ positions to generate compounds of Formula I. This chemistry is illustrated in Route 4.

Route 4

In an alternate embodiment, Structure 5-1 is coupled to an acid, Structure 5-2, to generate Structure 5-3. The carboxylic acid, Structure 5-3, is deblocked to generate a carboxylic acid which is Structure 5-4. Carboxylic acid Structure 5-4 is coupled to an amine to form the product amide (L-B) which is a compound within Formula I. This chemistry is illustrated in Route 5.

Route 5

In an alternate embodiment, Structure 6-1 is coupled to an amine to generate an amide (L-B) which is Structure 6-2. Structure 6-2 is coupled to an amine to generate compounds within Formula I. This chemistry is illustrated in Route 6.

Route 6

In another embodiment, a heteroaryl compound, for example, Structure 7-1 is iodinated to incorporate an iodide group at the R⁶ position. Other R⁶ groups can be introduced by those skilled in the art. For example, Structure 7-1 can be acylated to introduce an acyl group at the R⁶ position. Structure 7-2 is coupled to an activated ester, Structure 7-3, to generate Structure 7-4. In some embodiments, the leaving group, LG, is a halide. Structure 7-4 is treated with inorganic cyanide and two organometallic catalysts to generate a cyano group at the R⁶ position. In some embodiments, the inorganic cyanide is zinc cyanide. In some embodiments, the organometallic catalyst are Pd(dppf)₂ and Pd₂(dba)₃. Structure 7-4 is treated with an organic acid to generate Structure 7-5. In some embodiments, the organic acid is trifluoroacetic acid. Structure 7-5 is coupled to Structure 3, from Route 1, to generate compounds of Formula I. This chemistry is illustrated in Route 7.

Route 7

In another embodiment, a heteroaryl compound, for example, Structure 8-1, is coupled to an activated ester, Structure 8-2, to generate Structure 8-3. In some embodiments, R⁶ is C(O)OEt. In some embodiments, the leaving group, LG, is a halide. Structure 8-3 is treated with an organic acid to generate Structure 8-4. In some embodiments, the organic acid is trifluoroacetic acid. Structure 8-4 is coupled to Structure 3 from Route 1 to generate compounds of Formula I. In some embodiments, wherein R⁶ is C(O)OEt, the ester can be hydrolyzed and the acid used to generate an amide, —C(O)NH₂ at the R⁶ position. This chemistry is illustrated in Route 8.

Route 8

In another embodiment, a heteroaryl compound, Structure 9-1, is coupled to an activated ester, Structure 9-2, to generate Structure 9-3. In some embodiments, the leaving group, LG₁, is a halide. In some embodiments, LG is a halide. In some embodiments, Structure 9-3 is treated with an inorganic cyanide and two organometallic catalyst to generate structure 9-4. In some embodiments, the inorganic cyanide is zinc cyanide. In some embodiments, the two organometallic catalysts are Pd₂(dba)₃ and Pd(dppf)Cl₂. Structure 9-4 is treated with an organic acid to generate Structure 9-5. In some embodiments, the organic acid is trifluoroacetic acid. Structure 9-5 is coupled to Structure 3 from Route 1 to generate compounds of Formula I. This chemistry is illustrated in Route 9.

Route 9

In another embodiment, a heteroaryl compound, Structure 10-1, is coupled to an activated ester, Structure 10-2, to generate Structure 10-3. In some embodiments, the leaving group, LG₁, is a halide. In some embodiments, LG is a halide. In some embodiments, Structure 10-3 is treated with an inorganic cyanide and two organometallic catalyst to generate structure 10-4. In some embodiments, the inorganic cyanide is zinc cyanide. In some embodiments, the two organometallic catalysts are Pd₂(dba)₃ and Pd(dppf)Cl₂. Structure 10-4 is treated with an organic acid to generate Structure 10-5. In some embodiments, the organic acid is trifluoroacetic acid. Structure 10-5 is coupled to Structure 3 from Route 1 to generate compounds of Formula I. This chemistry is illustrated in Route 10.

Route 10

A central core that is directed linked to an aryl or heteroaryl group in place of the L-B region can be prepared according to known processes. For example, a central core is alkylated to generate a central core-A compound comprising a carboxylic acid is reduced to an alcohol and used to generate an alkyl halide. The alkyl halide is treated with a heteroaryl compound to generate a compound of Formula I. This chemistry can be carried out by those skilled in the art of organic chemistry. See for example: Advanced Organic Chemistry: Reactions, Mechanisms and Structure by J. March.

In one embodiment, a pyrrolidine compound is alkylated to generate a pyrrolidine-C(O)-A compound. The product is chlorinated alpha to the pyrrolidine and treated with base to generate an imine. The imine product is treated with a heteroaryl compound to generate a compound of Formula I. This chemistry can be carried out by those skilled in the art of organic chemistry. See for example: Advanced Organic Chemistry: Reactions, Mechanisms and Structure by J. March. In one embodiment, an amino indole is treated with phosgene or a phosgene equivalent to generate a compound of Formula I. This chemistry can be carried out by those skilled in the art of organic chemistry. See for example: Advanced Organic Chemistry: Reactions, Mechanisms and Structure by J. March.

Example 2 Examples of Central Synthons

Z^(A) is halogen.

In one embodiment, deuterated L-proline synthons are disclosed. Deuterated synthons include, but are not limited to, for example, the following compounds:

Structure A can be treated with deuterium oxide to generate Structure B. See, Barraclough, P. et al. Tetrahedron Lett. 2005, 46, 4653-4655; Barraclough, P. et al. Org. Biomol. Chem. 2006, 4, 1483-1491 and WO 2014/037480 (p. 103). Structure B can be reduced to generate Structure C. See, Barraclough, P. et al. Tetrahedron Lett. 2005, 46, 4653-4655; Barraclough, P. et al. Org. Biomol. Chem. 2006, 4, 1483-1491. Structure C can be treated with Mitsunobu reaction conditions to generate Structure D. Structure B can be treated with DAST to generate Structure E. See, WO 2014/037480. Structure A can be treated with sodium borodeuteride to generate Structure F. See, Dormoy, J.-R.; Castro, B. Synthesis 1986, 81-82. Compound F can be used to generate Structure K. See, Dormoy, J.-R.; Castro, B. Synthesis 1986, 81-82. Structure B can be treated with a deuterated reducing agent, for example sodium borodeuteride to generate Structure G. Structure G can be treated with DAST to generate Structure H. Structure F can be used to generate Structure K. See, Dormoy, J.-R.; Castro, B. Synthesis 1986, 81-82. Structure G can be used to generate Structure I. Structure J can be prepared according to Hruby, V. J. et al. J. Am. Chem. Soc. 1979, 101, 202-212. Structures A-J can be used to prepare compounds of Formula I.

Example 3 Preparation of Central-L-B Synthons

Routes 1a, 1b and 1c.

In Route 1a, 5-azaspiro[2.4]heptane-4,5-dicarboxylic acid, 5-(1,1-dimethylethyl) ester, (4S)-, CAS 209269-08-9, can be prepared as described in Tandon, M. et al. Bioorg. Med. Chem. Lett. 1998, 8, 1139-1144. In Step 2, the protected azaspiro[2.4]heptane is coupled to an amine in the presence of an organic solvent, a base and a coupling reagent to generate an amide bond; the L-B moiety. In one embodiment, the amine is (3-chloro-2-fluorophenyl) methanamine. In one embodiment, the organic solvent is DMF. In one embodiment, the base is diisopropylethylamine. In one embodiment, the coupling reagent is HATU. In Step 3, the protecting group is removed. In one embodiment, the starting material is reacted with an acid in the presence of an organic solvent. In one embodiment, the acid is 4N hydrochloric acid. In one embodiment, the organic solvent is dioxane.

In Route 1b, (4S) 4-oxazolidinecarboxylic acid, hydrochloride is treated with an amine protecting reagent. In one embodiment, the amine protecting reagent is di-tert-butyl dicarbonate. In another embodiment, 3,4-oxazolidinedicarboxylic acid, 3-(1,1-dimethylethyl) ester, (4S)-, is commercially available from JPM2 Pharmaceuticals. In one embodiment the reaction is carried out in an organic solvent in the presence of a base. In one embodiment, the organic solvent is acetonitrile. In one embodiment, the base is 4-dimentylaminopyridine (DMAP). In Step 2, the protected 4-oxazolidinecarboxylic acid is coupled to an amine in the presence of an organic solvent, a base and a coupling reagent to generate an amide bond; the L-B moiety. In one embodiment, the amine is (3-chloro-2-fluorophenyl) methanamine. In one embodiment, the organic solvent is DMF. In one embodiment, the base is diisopropylethylamine. In one embodiment, the coupling reagent is HATU. In Step 3, the protecting group is removed. In one embodiment, the starting material is reacted with an acid in the presence of an organic solvent. In one embodiment, the acid is 4N hydrochloric acid. In one embodiment, the organic solvent is dioxane.

In Route 1c, (S)-5-(tert-Butoxycarbonyl)-5-azaspiro[2.4]heptane-6-caboxylic acid, CAS 1129634-44-1, is commercially available from Ark Pharm. In Step 2, the carboxylic acid is coupled to an amine in the presence of an organic solvent, a base and a coupling reagent to generate an amide bond; the L-B moiety. In one embodiment, the amine is (3-chloro-2-fluorophenyl) methanamine. In one embodiment, the organic solvent is DMF. In one embodiment, the base is diisopropylethylamine. In one embodiment, the coupling reagent is HATU. In Step 3, the protecting group is removed. In one embodiment, the starting material is reacted with an acid in the presence of an organic solvent. In one embodiment, the acid is 4N hydrochloric acid. In one embodiment, the organic solvent is dioxane.

Routes 2a, 2b, 2c, and 2d.

In Route 2a, commercially available Boc-L-proline is coupled to an amine in the presence of an organic solvent, a base and a coupling reagent to generate an amide bond; the L-B moiety. In one embodiment, the amine is (3-chloro-2-fluorophenyl) methanamine. In one embodiment, the organic solvent is DMF. In one embodiment, the base is diisopropylethylamine. In one embodiment, the coupling reagent is HATU. In Step 2, the Boc protecting group is removed. In one embodiment, the starting material is reacted with an acid in the presence of an organic solvent. In one embodiment, the acid is 4N hydrochloric acid. In one embodiment, the organic solvent is dioxane.

In Route 2b, commercially available (1R, 3S, 5R)-2-[(tert-butoxy)carbonyl]-2-azabicyclo[3.1.0]hexane-3-carboxylic acid, from Enamine, is coupled to an amine in the presence of an organic solvent, a base and a coupling reagent to generate an amide bond; the L-B moiety. In one embodiment, the amine is (3-chloro-2-fluorophenyl) methanamine. In one embodiment, the organic solvent is DMF. In one embodiment, the base is diisopropylethylamine. In one embodiment, the coupling reagent is HATU. In Step 2, the Boc protecting group is removed. In one embodiment, the starting material is reacted with an acid in the presence of an organic solvent. In one embodiment, the acid is 4N hydrochloric acid. In one embodiment, the organic solvent is dioxane.

In Route 2c, commercially available (2S,4R)-1-(tert-butoxycarbonyl)-4-fluoropyrrolidine-2-carboxylic acid, from Manchester Organics, is coupled to an amine in the presence of an organic solvent, a base and a coupling reagent to generate an amide bond; the L-B moiety. In one embodiment, the amine is (3-chloro-2-fluorophenyl) methanamine. In one embodiment, the organic solvent is DMF. In one embodiment, the base is diisopropylethylamine. In one embodiment, the coupling reagent is HATU. In Step 2, the Boc protecting group is removed. In one embodiment, the starting material is reacted with an acid in the presence of an organic solvent. In one embodiment, the acid is 4N hydrochloric acid. In one embodiment, the organic solvent is dioxane.

In Route 2d, commercially available (S)-1-(tert-butoxycarbonyl)indoline-2-carboxylic acid, from Chem-Impex, is coupled to an amine in the presence of an organic solvent, a base and a coupling reagent to generate an amide bond; the L-B moiety. In one embodiment, the amine is (3-chloro-2-fluorophenyl) methanamine. In one embodiment, the organic solvent is DMF. In one embodiment, the base is diisopropylethylamine. In one embodiment, the coupling reagent is HATU. In Step 2, the Boc protecting group is removed. In one embodiment, the starting material is reacted with an acid in the presence of an organic solvent. In one embodiment, the acid is 4N hydrochloric acid. In one embodiment, the organic solvent is dioxane. This chemistry is illustrated in Scheme 2.

Additional starting materials that can readily be converted to Central-L-B-Synthons include, but are not limited to: (S)-1-(tert-butoxycarbonyl)-2,3-dihydro-1H-pyrrole-2-carboxylic acid, CAS 90104-21-5, available from Ark Pharm; cyclopent-1-ene-1,2-dicarboxylic acid, CAS 3128-15-2, purchased from Ark Pharm; imidazole, 1H-imidazole-1,2-dicarboxylic acid, 1-(1,1-dimethylethyl) 2-ethyl ester, CAS 553650-00-3, commercially available from FCH Group; Boc-L-octahydroindole-2-carboxylic acid can be purchased from Chem Impex. The compound,

can be prepared according to the procedures disclosed in WO 2004/111041; (S)-Boc-5-oxopyrrolidine-2-carboxylic acid is available from the Aldrich Chemical Co.; (1S,2S,5R)-3-(tert-butoxycarbonyl)-3-azabicyclo[3.3.0]hexane-2-carboxylic acid is available from Ark Pharm; (S)-3-Boc-thiazolidine-2-carboxylic acid is available from Alfa Aesar; (2S,4R)-1-(tert-butoxycarbonyl)-4-chloropyrrolidine-2-carboxylic acid is available from Arch Bioscience; (1S,3aR,6aS)-2-(tert-butoxycarbonyl)octahydrocyclopenta[c]pyrrole-1-carboxylic acid is available from Ark Pharm; 1,2-pyrrolidinedicarboxylic acid, 3-[[(phenylmethoxy)carbonyl]amino]-, 1-(1,1-dimethylethyl) ester, (2S,3R) can be prepared as disclosed in WO 2004/007501. The Cbz group can be removed and the amino group can be alkylated to generate central core compounds of the present invention.

The compound

can be prepared as disclosed by Braun, J.V.; Heymons, Albrecht Berichte der Deutschen Chemischen Gesellschaft [Abteilung] B: Abhandlungen (1930) 63B, 502-7.

The compounds (2S,3S,4S)-4-fluoro-3-methoxy-pyrrolidine-1,2-dicarboxylic acid 1-tert-butyl ester and (2R,3R,4R)-3-fluoro-4-methoxy-pyrrolidine-1,2-dicarboxylic acid 1-tert-butyl ester can be prepared as a mixture according to WO 2012/093101 to Novartis and the regioisomers can be ultimately separated once coupled to generate the central core-L-B synthons. The compound (S)-Boc-5-oxopyrrolidine-2-carboxylic acid is available from the Aldrich Chemical Co.

Example 4 Preparation of A-C(O)-Moiety

Examples of the preparation of the A-C(O)-Moiety can be found in Example 1 and below.

In an alternate embodiment, a heteroaryl compound of Structure 1-1 is acylated to generate Structure 1-2. In an alternate embodiment, Structure 1-1 is treated with an inorganic cyanide and organometallic catalysts to generate a compound where R⁶=cyano. The cyano compound can be treated with an oxime to generate an amide, —C(O)NH₂, at the R⁶ position. Structure 1-2 is coupled to an activated ester of Structure 1-3 to generate Structure 1-4. In some embodiments, the leaving group, LG, is a halide. The ester is hydrolyzed to generate acid Structure 1-5. This chemistry is illustrated in Route 4a.

Route 4a

In an alternate embodiment, a heteroaryl compound of Structure 2-1 is acylated to generate Structure 2-2. In an alternate embodiment, Structure 2-1 is treated with an inorganic cyanide and organometallic catalysts to generate a compound where R⁶=cyano. The cyano compound can be treated with an oxime to generate an amide, —C(O)NH₂, at the R⁶ position. Structure 2-2 is coupled to an activated ester of Structure 2-3 to generate Structure 2-4. In some embodiments, the leaving group, LG, is a halide. The ester group in Structure 2-4 is hydrolyzed to generate acid Structure 2-5. This chemistry is illustrated in Route 4b.

Route 4b

In an alternate embodiment, a heteroaryl compound of Structure 3-1 is acylated to generate Structure 3-2. In an alternate embodiment, Structure 3-1 is treated with an inorganic cyanide and organometallic catalysts to generate a compound where R⁶=cyano. The cyano compound can be treated with an oxime to generate an amide, —C(O)NH₂, at the R⁶ position. Structure 3-2 is coupled to an activated ester of Structure 3-3 to generate Structure 3-4. In some embodiments, the leaving group, LG, is a halide. The ester is hydrolyzed to generate an acid which is Structure 3-5. This chemistry is illustrated in Route 4c.

Route 4c Example 5 Coupling of Central-L-B-Synthons to A-C(O)-Moieties

Examples of the coupling of central-L-B-synthons to A-C(O)-moieties can be found in Example 1 and below.

In one embodiment, Structure 1-5, from Example 4 Route 4a, is coupled to Structure 3 from Route 1 to generate compounds of Formula I. This chemistry is illustrated in Route 5a.

Route 5a

In one embodiment, Structure 2-5 from Example 4 Route 4b is coupled to a central core-L-B to generate compounds of Formula I. This chemistry is illustrated in Route 5b.

Route 5b

In one embodiment, Structure 3-5, from Example 4 Route 4c, is coupled to Structure 3 from Route 1 to generate compounds of Formula I. This chemistry is illustrated in Route 5c.

Route 5c Example 6 Syntheses of Non-Limiting Examples of Compounds of Formula I

Step 1: 2′-Chloro-2-fluoro-[1,1′-biphenyl]-3-amine hydrochloride (SM3)

A mixture of SM1 (30 g), SM2 (60 g), K₂CO₃ (91 g), and Pd(dppf)₂Cl₂ (19.25 g) in solvent (dioxane 400 mL, H₂O 100 mL) was purged with argon in a pressure vessel for 5 min and stirred for 15 h at 100° C. The solvent was removed under reduced pressure and the remaining residue was purified by column chromatography. The purified material was then dissolved in MeOH and treated with HCl/MeOH. The solvent was removed under reduced pressure and the remaining solid was washed with IPA-heptane (1/1) to afford SM3.

Step 2: (2S,4R)-tert-Butyl 2-((2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate (SM5)

To an ice-cold solution of SM4 (530 mg) in DCM (20 mL) was added 1-chloro-N,N,2-trimethyl-1-propenylamine (0.333 mL, 1.1 equiv) dropwise with stirring. The stirring was continued for 3 h at this temperature and then solid SM3 (640 mg, 1.1 equiv) was added, followed by DIEA (1.12 mL, 3 equiv). The cooling bath was removed and the reaction mixture was stirred overnight at rt. The reaction mixture was then added to water (20 mL) and extracted with DCM (2×25 mL). The organic layer was washed successively with an aqueous solution of NaHCO₃ (20 mL), water (20 mL), and brine (20 mL), then dried over Na₂SO₄ and concentrated under reduced pressure. The remaining residue was purified by column chromatography (eluted with hexanes/EtOAc) to give SM5.

Step 3: (2S,4R)—N-(2′-Chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamide hydrochloride (Int-1)

(2S,4R)-tert-Butyl 2-((2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate SM5 (700 mg) was taken in 4 N HCl in dioxane (25 mL) and the resulting reaction mixture was stirred at rt for 3 h. The solvent was then removed under reduced pressure and the remaining residue Int-1 was used directly without further purification.

Step 1: (2S,4R)-tert-Butyl 2-((6-bromopyridin-2-yl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate (SM8)

To an ice-cold solution of SM6 (30 g) in DCM (600 mL) was added 1-chloro-N,N,2-trimethyl-1-propenylamine (18.7 mL, 1.1 equiv) dropwise with stirring. The stirring was continued for 3 h at this temperature. Solid SM7 (24.48 g, 1.1 equiv) was then added, followed by DIEA (67.2 mL, 3 equiv). The cooling bath was removed and the reaction mixture was stirred overnight at rt. The solvent was co-evaporated with MeOH (30 mL). The residue was then dissolved in chloroform (300 mL) and washed successively with cold 1 N aq HCl (3×200 mL), water (300 mL), and saturated aq NaHCO₃ (300 mL). The organic layer was dried (Na₂SO₄) and concentrated under reduced pressure. The remaining residue was stirred in a 1:1 solution of DCM and heptane (150 mL). The white solid was isolated by filtration and dried under high vacuum to afford SM8 (37.3 g).

Step 2: (2S,4R)—N-(6-Bromopyridin-2-yl)-4-fluoropyrrolidine-2-carboxamide TFA salt (Int-2)

SM8 was dissolved in DCM and equal volume of TFA was added. The mixture was stirred for 30 min at rt. The volatiles were removed under reduced pressure and the the residue Int-2 was used without further purification.

Step 1: 1H-Thieno[3,2-c]pyrazole (99b)

The title compound 99b (310 mg) was prepared from 3-bromothiophene-2-carbaldehyde 99a according to the literature (Airey, J. et al. Synthesis 2014, 96-100). ¹H NMR (400 MHz, CDCl₃, 300 K): δ 7.11 (s, 1H), 7.60 (s, 1H), 7.76+8.03 (1H), 13.33+13.0 (1H).

Step 2: 3-Iodo-1H-thieno[3,2-c]pyrazole (99c)

1H-Thieno[3,2-c]pyrazole 99b (310 mg, 2.5 mmol) in DMF (10 mL) was treated with iodine (954 mg, 3.76 mmol), followed by powdered KOH (421 mg, 7.5 mmol). The mixture was stirred overnight at rt. The mixture was diluted with water (50 mL), followed by addition of 10% Na₂S₂O₃ solution (5 mL). The mixture was extracted with ethyl acetate (3×50 mL). The combined organic extracts were washed with brine and dried over magnesium sulfate. The solution was filtered and concentrated, and the residue 99c was used in the next step without purification.

Step 3: tert-Butyl 2-(3-iodo-1H-thieno[3,2-c]pyrazol-1-yl)acetate (99d)

The residue 99c from Step 2 was dissolved in CH₃CN (50 mL). To this solution, tert-butyl 2-bromoacetate (634 mg, 0.48 mL, 3.25 mmol) and solid potassium carbonate (1.03 g, 7.5 mmol) were added. The mixture was refluxed overnight under an atmosphere of argon. The reaction mixture was cooled to rt and filtered through a pad of Celite®. The solid cake was washed with CH₃CN (20 mL), and the combined solution was concentrated under reduced pressure. The remaining residue was purified by column chromatography to afford pure compound 99d (610 mg) and impure isomer tert-butyl 2-(3-iodo-2H-thieno[3,2-c]pyrazol-2-yl)acetate (130 mg). ¹H NMR (400 MHz, CDCl₃): δ 1.45 (s, 9H), 4.93 (s, 2H), 6.93 (d, J=5.2 Hz, 1H), 7.42 (d, J=5.2 Hz, 1H). LC/MS (EI) m/z: [M+H]⁺ 365.

Step 4: tert-Butyl 2-(3-cyano-1H-thieno[3,2-c]pyrazol-1-yl)acetate (99e)

To a degassed solution of t-butyl 2-(3-iodo-1H-thieno[3,2-c]pyrazol-1-yl)acetate 99d (610 mg, 1.67 mmol) in the co-solvents DMF (14 mL) and water (2 mL) were added Zn(CN)₂ (235 mg, 2.0 mmol), Pd(dppf)₂ (125 mg, 0.17 mmol), and Pd₂(dba)₃ (156 mg, 0.17 mmol) under an atmosphere of argon. The mixture was heated at 110° C. for 6 h. The reaction mixture was cooled to rt and the volatiles were removed under reduced pressure. The remaining residue was diluted with ethyl acetate (50 mL) and filtered through a pad of Celite®. The solid was washed with ethyl acetate (30 mL). The combined organic solution was concentrated under reduced pressure and the remaining residue was purified by column chromatography to afford the title compound 99e (290 mg). ¹H NMR (400 MHz, CDCl₃, 300 K): δ 1.47 (s, 9H), 5.0 (s, 2H), 6.93 (d, J=5.2 Hz, 1H), 7.52 (d, J=5.2 Hz, 1H). LC/MS (EI) m/z: [M+H]⁺ 264.

Step 5: 2-(3-Carbamoyl-1H-thieno[3,2-c]pyrazol-1-yl)acetic acid (99f)

A solution of tert-butyl 2-(3-cyano-1H-thieno[3,2-c]pyrazol-1-yl)acetate (59 mg, 0.22 mmol) in TFA (2 mL) was subjected to microwave irradiation at 140° C. for 30 min. The mixture was concentrated under reduced pressure, and the residue was co-evaporated with toluene (10 mL) twice. The dried residue 99f was used directly in the next step. LC/MS (EI) m/z: 226.

Step 6: 1-(2-((2S,4R)-2-((2′-Chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-thieno[3,2-c]pyrazole-3-carboxamide (99)

To a solution of the residue 99f (0.22 mmol) from Step 5 was added (2S,4R)—N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamide hydrochloride Int-1 (90 mg, 0.24 mmol) in DMF (2 mL) followed by HATU (109 mg, 0.29 mmol) and dropwise addition of DIEA (0.3 mL) at rt. The reaction mixture was stirred for 1 h at rt and the volatiles were removed under reduced pressure. The residue was diluted with 20 mL of 10% sodium carbonate and extracted with ethyl acetate (3×20 mL). The combined organic solution was washed with water and brine, and then dried over MgSO₄. The solution was filtered and the solvent was removed under reduced pressure. The remaining residue was purified by column chromatography to afford 99 (50.7 mg). ¹H NMR (400 MHz, DMSO-d₆, 300 K): (major rotamer) δ 2.00-2.19 (m, 1H), 2.47-2.53 (m, 1H), 3.75-3.88 (m, 1H), 4.02-4.11 (m, 1H), 4.70 (t, J=8.8 Hz, 1H), 5.26 (d, J=17.2 Hz, 1H), 5.38-5.49 (m, 2H), 6.97-7.01 (m, 1H), 7.05 (d, J=5.2 Hz, 1H), 7.15 (t, J=7.6 Hz, 1H), 7.30-7.41 (m, 4H), 7.51-7.54 (m, 2H), 7.60-7.62 (m, 1H), 7.89-7.93 (m, 1H), 9.92 (s, 1H); ¹⁹F NMR (376 MHz, DMSO-d₆, 300K): (major rotamer) δ −126.8, −175.8. LC (method A): t_(R)=1.94 min. LC/MS (EI) m/z: [M+H]⁺ 544.

To a solution of 2-(3-carbamoyl-1H-thieno[3,2-c]pyrazol-1-yl)acetic acid 99f (0.193 mmol) was added (2S,4R)—N-(6-bromopyridin-2-yl)-4-fluoropyrrolidine-2-carboxamide hydrochloride (0.212 mmol) in DMF (1.5 mL) followed by TBTU (93 mg, 0.29 mmol) and dropwise addition of DIEA (0.21 mL, 1.2 mmol). The reaction mixture was stirred for 0.5 h at rt, then quenched by aq NaHCO₃ (5 mL). The precipitate was collected by filtration and purified by column chromatography (eluent: 5% MeOH in DCM) to give 106 (68 mg). ¹H NMR (400 MHz, CDCl₃-CD₃OD, 300 K): (major rotamer) δ 2.37 (m, 1H), 2.39-2.41 (m, 1H), 2.59-2.70 (m, 1H), 3.65 (dd, J=36.0, 12.4 Hz, 1H), 3.90-3.98 (dd, J=20.0, 12.0 Hz, 1H), 4.80 (t, J=8.0 Hz, 1H), 5.18 (d, J=8.0 Hz, 1H), 5.4 (m, 1H), 6.96 (d, J=8.0 Hz, 1H), 7.22 (d, J=8.0 Hz, 1H), 7.50 (d, J=4.0 Hz, 1H), 7.55 (t, J=8.0 Hz, 1H), 8.14 (d, J=8.0 Hz, 1H). ³¹F NMR (376 MHz, CDCl₃-CD₃OD, 300 K): (major rotamer) δ −177.0. LC (method A): t_(R)=1.33 min. LC/MS (EI) m/z: [M+H]⁺ 497.

To a solution of 2-(3-carbamoyl-1H-thieno[3,2-c]pyrazol-1-yl)acetic acid 99f (0.287 mmol) was added (1R,3S,5R)—N-(3-chloro-2-fluorobenzyl)-2-azabicyclo[3.1.0]hexane-3-carboxamide hydrochloride (48 mg, 0.158 mmol) in DMF (1.5 mL) followed by TBTU (69 mg, 0.216 mmol) and dropwise addition of DIEA (0.13 mL, 0.75 mmol). The reaction mixture was stirred for 0.5 h at rt, then quenched by aq NaHCO₃ (5 mL). The mixture was extracted with EtOAc (30 mL) and the organic layer was washed with water and brine. The solvent was removed under reduced pressure and the remaining residue was purified by column chromatography (eluent: 5% MeOH in DCM) to give 109 (57 mg). ¹H NMR (400 MHz, CDCl₃, 300 K): (major rotamer) δ 0.59-0.61 (m, 1H), 1.08-1.12 (m, 1H), 1.95-2.06 (m, 3H), 2.70-2.72 (m, 1H), 3.34-3.62 (m, 1H), 4.41 (s, 2H), 4.57-4.60 (m, 1H), 5.21-5.32 (m, 2H), 6.00 (s, 1H), 6.70 (s, 1H), 6.84-6.85 (m, 1H), 6.92-6.94 (m, 1H), 7.11-7.13 (m, 1H), 7.21-7.26 (m, 1H), 7.36-7.38 (m, 1H), 7.43 (m, 1H). ¹³C NMR (100 MHz, CDCl₃, 300 K): (major rotamer) δ 19.40, 20.74, 29.97, 37.14, 37.52, 53.43, 65.54, 108.95, 120.76, 120.94, 123.07, 124.58, 124.63, 126.83, 126.98, 127.93, 129.56, 134.78, 137.27, 150.91, 154.84, 157.30, 163.16, 167.60, 170.45. ³¹F NMR (376 MHz, CDCl₃, 300 K): (major rotamer) δ −120.9. LC (method A): t_(R)=1.49 min. LC/MS (EI) m/z: [M+H]⁺ 476.

Step 1: 3-Bromo-5-methylthiophene-2-carbaldehyde (113b)

To a solution of 4-bromo-2-methylthiophene 113a (11 g, 62 mmol) in anhydrous THF (100 mL) cooled to −78° C. was added dropwise a 2 M LDA-THF solution (34 mL, 68 mmol) under an atmosphere of argon. The mixture was stirred for 2 h at −78° C. and then anhydrous DMF (9.6 mL, 124 mmol) was added. The reaction mixture was kept at −78° C. for 1 h and quenched with 10% aq citric acid (10 mL). The volatiles were removed under reduced pressure and the remaining residue was diluted with ethyl acetate (150 mL). The organic layer was successively washed with 5% aq citric acid (80 mL), water (100 mL), and brine (50 mL), and then dried over MgSO₄. The solution was filtered and concentrated under reduced pressure to afford 113b (12.3 g) as a pale yellow oil, which was used in the next step without further purification.

Step 2: 5-Methyl-1H-thieno[3,2-c]pyrazole (113c)

The title compound 113c (3.0 g) was prepared from 3-bromo-5-methylthiophene-2-carbaldehyde 113b (12.2 g) in a manner similar to that reported in the literature (Airey, J. et al. Synthesis 2014, 96-100). ¹H NMR (400 MHz, CDCl₃, 300 K): δ 2.49 (s, 3H), 6.86 (s, 1H), 7.65+7.89 (1H), 12.83+13.10 (1H). LC/MS (EI) m/z: [M+H]⁺ 139.

Step 3: 3-Iodo-5-methyl-1H-thieno[3,2-c]pyrazole (113d)

The title compound 113d was prepared from 5-methyl-1H-thieno[3,2-c]pyrazole (1.0 g) in a manner similar to that described in Step 2 of Scheme 3.

Step 4: tert-Butyl 2-(3-iodo-5-methyl-1H-thieno[3,2-c]pyrazol-1-yl)acetate (113e)

The title compound 113e was prepared from 3-iodo-5-methyl-1H-thieno[3,2-c]pyrazole in a similar manner as described in Step 3 of Scheme 3. ¹H NMR (400 MHz, CDCl₃): 1.46 (s, 9H), 2.53 (s, 3H), 4.87 (s, 2H), 6.64 (s, 1H) ppm. MH⁺379.09. Minor product is tert-butyl 2-(3-iodo-5-methyl-2H-thieno[3,2-c]pyrazol-2-yl)acetate. ¹H NMR (400 MHz, CDCl₃, 300 K): δ 1.47 (s, 9H), 2.51 (s, 3H), 4.98 (s, 2H), 6.80 (s, 1H). LC/MS (EI) m/z: [M+H]⁺ 379.

Step 5: tert-Butyl 2-(3-cyano-5-methyl-1H-thieno[3,2-c]pyrazol-1-yl)acetate (113f)

The title compound 113f was prepared from tert-butyl 2-(3-iodo-5-methyl-1H-thieno[3,2-c]pyrazol-1-yl)acetate (823 mg, 2.15 mmol) in a manner similar to that described in Step 4 of Scheme 3. ¹H NMR (400 MHz, CDCl₃, 300 K): δ 1.47 (s, 9H), 2.56 (s, 3H), 4.93 (s, 2H), 6.65 (s, 1H). LC/MS (EI) m/z: [M+H]⁺ 278.

Step 6: 2-(3-Carbamoyl-5-methyl-1H-thieno[3,2-c]pyrazol-1-yl)acetic acid (113g)

The title compound 113g was prepared from tert-butyl 2-(3-cyano-5-methyl-1H-thieno[3,2-c]pyrazol-1-yl)acetate (143 mg) in a manner similar to that described in Step 5 of Scheme 3. LC/MS (EI) m/z: [M+H]+ 240.

Step 7: 1-(2-((2S,4R)-2-((2′-Chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-5-methyl-1H-thieno[3,2-c]pyrazole-3-carboxamide (113)

The title compound 113 (86.9 mg) was prepared from 2-(3-carbamoyl-5-methyl-1H-thieno[3,2-c]pyrazol-1-yl)acetic acid (105 mg, 0.3 mmol) in a manner similar to that described in Step 6 of Scheme 3. ¹H NMR (400 MHz, DMSO-d₆, 300 K): (major rotamer) δ 2.06-2.19 (m, 1H), 2.39 (s, 3H), 2.40-2.55 (m, 1H), 3.74-3.87 (m, 1H), 4.02-4.10 (m, 1H), 4.69 (t, J=8.8 Hz, 1H), 5.18 (d, J=17.2 Hz, 1H), 5.31-5.51 (m, 2H), 6.79 (s, 1H), 7.0 (t, J=7.2 Hz, 1H), 7.15 (t, J=8.0 Hz, 1H), 7.24-7.46 (m, 4H), 7.50-7.53 (m, 2H), 7.87-7.92 (m, 1H), 9.92 (s, 1H); ¹⁹F NMR (376 MHz, DMSO-d₆, 300K): (major rotamer) δ −126.71, −175.87. LC (method A): t_(R)=2.10 min. LC/MS (EI) m/z: [M+H]⁺ 558.

Step 1: Ethyl 1-(2-(tert-butoxy)-2-oxoethyl)-4,5,6,7-tetrahydro-1H-indazole-3-carboxylate (104b)

To a solution of ethyl 4,5,6,7-tetrahydro-1H-indazole-3-carboxylate 104a (1.03 g, 5.35 mmol) in CH₃CN (50 mL) was added tert-butyl 2-bromoacetate (1.17 g, 0.89 mL, 6.0 mmol) and potassium carbonate (1.5 g, 10.6 mmol). The mixture was refluxed overnight under an atmosphere of argon. LC-MS analysis indicated two isomers were formed in a ratio of 4:1. The reaction mixture was cooled to rt and filtered through a pad of Celite®. The solid cake was washed with CH₃CN (20 mL), and the combined solution was concentrated under reduced pressure. The remaining residue was purified by column chromatography to afford the major isomer ethyl 1-(2-(tert-butoxy)-2-oxoethyl)-4,5,6,7-tetrahydro-1H-indazole-3-carboxylate 104b (1.37 g) and the minor isomer ethyl 2-(2-(tert-butoxy)-2-oxoethyl)-4,5,6,7-tetrahydro-2H-indazole-3-carboxylate 104c (0.28 g). ¹HNMR (400 MHz, CDCl₃, 300 K): (major isomer) δ 1.38 (t, J=7.2 Hz, 3H), 1.45 (s, 9H), 1.75 (m, 2H), 1.82 (m, 2H), 2.52 (t, J=5.2 Hz, 2H), 2.75 (t, J=5.2 Hz, 2H), 4.37 (q, J=7.2 Hz, 2H), 4.77 (s, 2H). LC/MS (EI) m/z: 309. ¹H NMR (400 MHz, CDCl₃, 300 K): (minor isomer) δ 1.35 (t, J=7.2 Hz, 3H), 1.47 (s, 9H), 1.74-1.80 (m, 4H), 2.67 (t, J=5.2 Hz, 2H), 2.75 (t, J=5.2 Hz, 2H), 4.30 (q, J=7.2 Hz, 2H), 5.11 (s, 2H). LC/MS (EI) m/z: [M+H]⁺ 309.

Step 2: 2-(3-(Ethoxycarbonyl)-4,5,6,7-tetrahydro-1H-indazol-1-yl)acetic acid (104d)

Ethyl 1-(2-(tert-butoxy)-2-oxoethyl)-4,5,6,7-tetrahydro-1H-indazole-3-carboxylate 104b (1.35 g, 4.38 mmol) was treated with TFA (5 mL) and DCM (5 mL) and stirred overnight at rt. The volatiles were removed under reduced pressure and the remaining residue was co-evaporated with toluene (10 mL) twice. The dried residue 104d was used directly in the next step.

Step 3: Ethyl 1-(2-((2S,4R)-2-((2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-4,5,6,7-tetrahydro-1H-indazole-3-carboxylate (104e)

To a solution of the residue 104d from Step 2 (375 mg, 1.5 mmol) was added (2S,4R)—N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamide hydrochloride (560 mg, 1.5 mmol) in DMF (2 mL) followed by HATU (741 mg, 1.95 mmol) and dropwise addition of DIEA (4.5 mmol, 0.78 mL). The mixture was stirred for 1 h at rt and the volatiles were removed under reduced pressure. The remaining residue was diluted with 10% aq sodium carbonate (20 mL) and water (50 mL), then extracted with ethyl acetate (3×50 mL). The combined organic extract was washed with water and brine, then dried over MgSO₄. The solution was filtered and the solvent was removed under reduced pressure. The remaining residue was purified by column chromatography to afford the title compound 104e (608 mg). LC/MS (EI) m/z: [M+H]⁺ 571.

Step 4: 1-(2-((2S,4R)-2-((2′-Chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-4,5,6,7-tetrahydro-1H-indazole-3-carboxylic acid (104f)

Compound 104e from Step 3 (608 mg, 1.06 mmol) was dissolved in a mixture of MeOH-THF-H₂O (3 mL-3 mL-3 mL) and treated with LiOH (100 mg, 4.25 mmol). The reaction mixture was stirred overnight at rt. The volatiles were removed under reduced pressure and the remaining residue was acidified with 10% aq citric acid (10 mL). The solid 104f was collected by filtration, washed with water, and dried in vacuo for use in the next step. LC/MS (EI) m/z: [M+H]⁺543.

Step 5: 1-(2-((2S,4R)-2-((2′-Chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-4,5,6,7-tetrahydro-1H-indazole-3-carboxamide (104)

Acid 104f (252 mg, 0.46 mmol) from Step 4 was mixed with NH₄Cl (125 mg, 2.32 mmol) in DMF (3 mL). To this solution was added HATU (262 mg, 0.69 mmol) followed by dropwise addition of DIEA (1.38 mmol, 0.24 mL). The mixture was stirred for 3 h at rt and the volatiles were removed under reduced pressure. The remaining residue was diluted with 10% aq sodium carbonate (15 mL) and water (15 mL), and then extracted with ethyl acetate (3×25 mL). The combined organic solution was washed with water and brine, and then dried over MgSO₄. The mixture was filtered and the filtrate was concentrated under reduced pressure. The remaining residue was purified by column chromatography to afford the title compound 104 (160 mg). ¹H NMR (400 MHz, DMSO-d₆, 300 K): (major rotamer) δ 1.53-1.61 (m, 4H), 1.99-2.16 (m, 1H), 2.38-2.41 (m, 3H), 2.54-2.56 (m, 2H), 3.40-3.53 (m, 1H), 3.93-4.07 (m, 1H), 4.68 (t, J=8.8 Hz, 1H), 4.90-5.14 (m, 2H), 5.36-5.49 (1H), 6.93-7.19 (m, 4H), 7.32-7.43 (m, 3H), 7.52-7.54 (m, 1H), 7.92 (t, J=6.8 Hz, 1H), 9.90 (s, 1H); ¹⁹F NMR (376 MHz, DMSO-d₆, 300K): (major rotamer) δ −126.8, −176.06. LC (method A): t_(R)=2.02 min. LC/MS (EI) m/z: [M+H]⁺ 542.

Step 1: Methyl 2-(3-acetyl-8-(3-chlorophenyl)-1H-pyrazolo[4,3-g]indolizin-1-yl)acetate (105c)

A mixture of 1-(1-azidovinyl)-3-chlorobenzene 105a (0.05 g) (prepared as reported by Donthiri et al. J. Org. Chem 2014, 79, 11277-11284), methyl 2-(3-acetyl-1H-pyrazolo[3,4-c]pyridin-1-yl)acetate 105b (0.195 g), CuI (1 mg) and 4 Å molecular sieves was placed in a vial and dry acetonitrile (3 mL) was added. The sealed vial was heated at 65° C. for 24 h. The reaction mixture was allowed to cool to rt and the solvent was removed under reduced pressure. The remaining residue was purified by column chromatography (eluent: DCM) to give 105c (20 mg) as a light orange solid.

Step 2: 2-(3-Acetyl-8-(3-chlorophenyl)-1H-pyrazolo[4,3-g]indolizin-1-yl)acetic acid (105d)

The solid 105c (20 mg, 0.052 mmol) from Step 1 was taken in THF (3 mL), water (0.3 mL), and MeOH (1 mL), and then 1 N aq NaOH (1 mL) was added. The resulting mixture was stirred at rt overnight and concentrated under reduced pressure. The remaining residue was diluted with EtOAc and water. The organic layer was separated and the aq layer was extracted repeatedly with EtOAc. The combined organic layer was dried and concentrated to give 105d as a light yellow solid, which was used as such in the next step.

Step 3: (2S,4R)-1-(2-(3-Acetyl-8-(3-chlorophenyl)-1H-imidazo[1,2-a]pyrazolo[3,4-c]pyridin-1-yl)acetyl)-N-(6-bromopyridin-2-yl)-4-fluoropyrrolidine-2-carboxamide (105)

To a solution of 2-(3-acetyl-8-(3-chlorophenyl)-1H-pyrazolo[4,3-g]indolizin-1-yl)acetic acid 105d (0.052 mmol) and (2S,4R)—N-(6-bromopyridin-2-yl)-4-fluoropyrrolidine-2-carboxamide TFA salt (0.05 mmol) in DMF (1 mL) cooled to 0-5° C. was added DIEA (47 μL). HATU (24 mg) was then added to this cooled solution and the cooling bath was removed. The reaction mixture was stirred at rt for 30 min and poured into water (10 mL) with stirring. The solid was isolated by filtration and purified by column chromatography (eluent: 0-1.5% MeOH in DCM) to afford 105 (10 mg) as light yellow solid. ¹H NMR (400 MHz, CDCl₃, 300 K): (major rotamer) δ 2.48-2.52 (m, 1H), 2.73 (s, 3H), 2.78-2.94 (m, 1H), 4.04-4.27 (m, 2H), 4.95 (t, J=7.6 Hz, 1H), 5.51 (d, J=52.4 Hz, 1H), 5.77 (d, J=16 Hz, 1H), 5.88 (d, J=16 Hz, 1H), 6.99 (d, J=8.4 Hz, 1H), 7.19-7.23 (m, 2H), 7.54-7.56 (m, 1H), 7.69-7.71 (m, 2H), 7.75 (d, J=8 Hz, 1H), 7.85 (s, 1H), 7.87 (d, J=7.2 Hz, 1H), 8.97 (br s, 1H); ³¹F NMR (376 MHz, CDCl₃, 300 K): (major rotamer) δ −176.04; LC (method A): t_(R)=2.60 min. LC/MS (EI) m/z: [M+H]⁺ 640.

Step 1: 7-Bromo-1H-indazole-3-carboxamide (111b)

To a solution of bromoindazole 111a (3 g) in DMF (30 mL) were added ammonium chloride (1.8 g) and DIEA (10.38 mL). The reaction mixture was cooled in an ice bath and then HATU (5.7 g) was added. The reaction mixture was warmed to rt and stirred overnight. The reaction mixture was poured into water (300 mL) containing LiOH (630 mg). The product was isolated by filtration and washed with water. The tan colored solid was dried under high vacuum to give 111b (2.15 g).

Step 2: tert-Butyl 2-(7-bromo-3-carbamoyl-1H-indazol-1-yl)acetate (11c)

A mixture of 7-bromo-1H-indazole-3-carboxamide 111b (2.15 g), tert-butyl bromoacetate (1.45 mL), and potassium carbonate (1.36 g) in anhydrous acetonitrile (40 mL) was refluxed for 2 h. The reaction mixture was then cooled to rt and the solvent was removed under reduced pressure. The remaining residue was sonicated with water (40 mL) and filtered. The solid obtained was washed thoroughly with water and further washed with 2:1 mixture of tert-butyl methyl ether and heptane (30 mL) and dried under high vacuum to give 111c (2.5 g).

Step 3: tert-Butyl 2-(3-carbamoyl-7-cyano-1H-indazol-1-yl)acetate (111d)

A mixture of tert-butyl 2-(7-bromo-3-carbamoyl-1H-indazol-1-yl)acetate 111c (0.5 g), zinc cyanide (0.198 g), Pd(dppf)Cl₂ (0.115 g), and Pd₂(dba)₃ (0.129 g) in DMF (5 mL) and water (1 mL) was bubbled with argon for 5 min. The vial was then sealed and heated at 80° C. for 3 h. After cooling the reaction mixture to rt, it was diluted with EtOAc. The mixture was then washed with water and a saturated aq NaHCO₃ solution. The separated organic layer was dried (Na₂SO₄) and concentrated. The remaining residue was purified by column chromatography (0-2% MeOH in DCM) to give a slightly yellow solid (0.3 g). The solid was then washed with ether (3 mL) to give 111d (0.23 g) as a colorless solid.

Step 4: 2-(3-Carbamoyl-7-cyano-1H-indazol-1-yl)acetic acid (111e)

The title compound 111e was prepared from tert-butyl 2-(3-carbamoyl-7-cyano-1H-indazol-1-yl)acetate (50 mg) in a manner similar to that described in Step 2 of Scheme 7, and used in the next step without further purification.

Step 5: 1-(2-((2S,4R)-2-((2′-Chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-7-cyano-1H-indazole-3-carboxamid (111)

2-(3-Carbamoyl-7-cyano-1H-indazol-1-yl)acetic acid 111e from Step 4 above was coupled with (2S,4R)—N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamide hydrochloride using the procedure described in Step 6 of Scheme 3. The crude product was purified by column chromatography (0-2% MeOH in DCM) to afford the title compound 111 (50 mg). ¹H NMR (400 MHz, CD₃OD, 300 K): (major rotamer) δ 2.65-2.75 (m, 1H), 4.1-4.14 (m, 1H), 4.16-4.24 (m, 1H), 4.89 (t, J=8.4 Hz, 1H), 5.52 (d, J=52.8 Hz, 1H), 5.73 (d, J=17.6 Hz, 1H), 5.89 (d, J=17.6 Hz, 1H), 7.07 (t, J=7.2 Hz, 1H), 7.19 (t, J=8 Hz, 1H), 7.28-7.44 (m, 5H), 7.49-7.59 (m, 1H), 7.87 (d, J=7.2 Hz, 1H), 7.91 (s, 1H), 7.97 (t, J=7.2 Hz, 1H), 8.59 (d, J=8 Hz, 1H). ³¹F NMR (376 MHz, CD₃OD, 300 K): (major rotamer) δ −178.5, −128.8. LC (method A): t_(R)=2.09 min. LC/MS (EI) m/z: [M+H]⁺ 563.

Step 1: 1-(3′-Amino-6-chloro-2′-fluoro-[1,1′-biphenyl]-3-yl)ethanone (117c)

To a mixture of 3-bromo-2-fluoroaniline 117a (1.0 g), (5-acetyl-2-chlorophenyl)boronic acid 117b (3.132 g), Pd(dppf)Cl₂ (0.860 g), and K₂CO₃ (3.64 g) under an atmosphere of argon was added dioxane (40 mL) and water (10 mL). The mixture was bubbled with argon for 5 min and heated with stirring at 100° C. overnight. The reaction mixture was then filtered through a pad of Celite® and the filtrate was concentrated under reduced pressure. The remaining residue was purified by column chromatography (0-0.5% MeOH in DCM) to afford 117c (0.9 g) as orange-yellow oil.

Step 2: (2S,4R)-tert-Butyl 2-((5′-acetyl-2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate (117d)

To an ice-cold solution of (2S,4R)-1-(tert-butoxycarbonyl)-4-fluoropyrrolidine-2-carboxylic acid (0.25 g, 1.07 mmol) in DCM (15 mL) was added 1-chloro-N,N,2-trimethylprop-1-en-1-amine (1.2 mmol, 0.16 mL, 1.1 equiv) dropwise with stirring. The stirring was continued for 3 h at this temperature. Solid 1-(3′-amino-6-chloro-2′-fluoro-[1,1′-biphenyl]-3-yl)ethanone 117c (256 mg, 0.97 mmol) was then added, followed by DIEA (0.56 mL, 3.6 mmol, 3 equiv). The cooling bath was removed and the reaction mixture was stirred overnight at rt. The solvent was co-evaporated with MeOH (3 mL). The remaining residue was then dissolved in chloroform (30 mL) and washed successively with cold 1 N aq HCl (3×20 mL), water (30 mL), and a saturated aq NaHCO₃ solution (30 mL). The organic layer was dried (Na₂SO₄) and concentrated under reduced pressure. Finally, the residue was stirred with a 1:1 solution of DCM and heptane (15 mL). The product was isolated by filtration and dried under high vacuum to give 117d (0.2 g) as a white solid.

Step 3: (2S,4R)—N-(5′-Acetyl-2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamide TFA salt (117e)

(2S,4R)-tert-Butyl 2-((5′-acetyl-2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate 117d (110 mg) was stirred in DCM (2 mL) and TFA (2 mL) for 30 min. The volatiles were removed under reduced pressure and the resulting residue 117e was used as such for the next step.

Step 4: 1-(2-((2S,4R)-2-((5′-Acetyl-2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indazole-3-carboxamide (117)

The title compound 117 was prepared in a manner similar to that described in Step 3 of Scheme 8. Thus, (2S,4R)—N-(5′-acetyl-2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamide TFA salt 117e (obtained from Step 3) was coupled with 2-(3-carbamoyl-1H-indazol-1-yl)acetic acid (0.05 g) using HATU (0.104 g) and DIEA (0.2 mL) in DMF (1.5 mL). The crude product was purified by column chromatography (0-2% MeOH in DCM) to give 117 (60 mg). ¹H NMR (400 MHz, CD₃OD, 300 K): (major rotamer) δ 2.65-2.75 (m, 1H), 3.91-4.04 (m, 1H), 4.20-4.29 (m, 1H), 4.84 (t, J=8 Hz, 1H), 5.48 (d, J=52 Hz, 1H), 5.42 (d, J=17.2 Hz, 1H), 5.57 (d, J=17.2 Hz, 1H), 7.12 (t, J=6.8 Hz, 1H), 7.21-7.32 (m, 2H), 7.43 (t, J=7.2 Hz, 1H), 7.59 (d, J=8.4 Hz, 1H), 7.65 (d, J=8.4 Hz, 1H), 7.89 (s, 1H), 7.93 (s, 1H), 7.96-8.02 (m, 2H), 8.22 (d, J=8 Hz, 1H). ³¹F NMR (376 MHz, CD₃OD, 300 K): (major rotamer) δ −128.5, −178.6 ppm. LC (method A): t_(R)=1.92 min. LC/MS (EI) m/z: [M+H]⁺ 580.

Step 1: tert-Btyl 2-(4-bromo-3-carbamoyl-1H-pyrazol-1-yl)acetate (110b)

A mixture of 4-bromo-1H-pyrazole-3-carboxamide 110a (1.0 g, 5.26 mmol), tert-butyl bromoacetate (1.13 g, 0.84 mL 5.78 mmol), and potassium carbonate (798 mg, 5.78 mmol) in anhydrous acetonitrile (20 mL) was refluxed for 5 h. The reaction mixture was then cooled to rt and the solvent was removed under reduced pressure. The residue was taken in a 1:1 mixture of DCM and water (100 mL:100 mL). The two layers were separated and the organic layer was washed with water (2×100 mL). Finally, the organic layer was dried (Na₂SO₄) and concentrated. The resulting residue was purified by column chromatography to give tert-butyl 2-(4-bromo-3-carbamoyl-1H-pyrazol-1-yl)acetate 110b.

Step 2: tert-Butyl 2-(3-carbamoyl-4-(2-methoxypyrimidin-5-yl)-1H-pyrazol-1-yl)acetate (110c)

A mixture of tert-butyl 2-(4-bromo-3-carbamoyl-1H-pyrazol-1-yl)acetate 110b (150 mg, 0.49 mmol), (2-methoxypyrimidin-5-yl)boronic acid (154 mg, 1 mmol), cesium carbonate (380 mg, 1.17 mmol), and DMF (2 mL) was purged with argon in a pressure vessel for 5 min. Tetrakis(triphenylphosphine)palladium (0) (30 mg, 0.025 mmol) was then added under argon and the pressure vessel was sealed and irradiated with microwaves at 90° C. for 30 min. The reaction mixture was cooled to rt and the solvent was removed under reduced pressure. The remaining residue was purified by column chromatography to give 110c.

Step 3: 2-(3-Carbamoyl-4-(2-methoxypyrimidin-5-yl)-1H-pyrazol-1-yl)acetic acid (110d)

tert-Butyl 2-(3-carbamoyl-4-(2-methoxypyrimidin-5-yl)-1H-pyrazol-1-yl)acetate 110c (120 mg, 0.36 mmol) in DCM (5 mL) was treated with TFA (5 mL). After completion of the reaction (as judged by LC-MS analysis), the solvent was removed under reduced pressure. The remaining material 110d was used directly in the next step.

Step 4: 1-(2-((2S,4R)-2-((2′-Chloro-2-fluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-4-(2-methoxypyrimidin-5-yl)-1H-pyrazole-3-carboxamide (110)

2-(3-Carbamoyl-4-(2-methoxypyrimidin-5-yl)-1H-pyrazol-1-yl)acetic acid 110d (0.36 mmol) from Step 3 was dissolved in DMF (4 mL) and DIEA (1.8 mmol) was added, which was followed by the addition of (2S,4R)—N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamide hydrochloride (120 mg, 0.32 mmol) at 5° C. HATU (287 mg, 0.76 mmol) was then added slowly at this temperature and the reaction mixture was stirred for 3 h at rt. The reaction mixture was then added to water (50 mL+10 g solid NaCl) and extracted with DCM (2×25 mL). The organic layer was washed successively with an aq solution of NaHCO₃ (20 mL), water (20 mL), and brine (20 mL), then dried over Na₂SO₄ and concentrated under reduced pressure. The remaining residue was purified by column chromatography (eluted with DCM/CH₃OH) to give the title compound 110. ¹H NMR (400 MHz, DMSO-d₆, 300 K): (major rotamer) δ 2.20-2.26 (m, 1H), 2.51-2.62 (m, 1H), 3.79-3.91 (m, 1H), 3.94 (s, 3H), 4.09-4.17 (m, 1H), 4.80 (t, J=8.0 Hz, 1H), 5.17-5.41 (m, 2H), 5.50 (d, J=7 Hz, 1H), 7.08 (t, J=7.2 Hz, 1H), 7.24 (t, J=8.0 Hz, 1H), 7.30 (s, 1H), 7.39-7.47 (m, 4H), 7.58-7.61 (m, 1H), 7.96-8.13 (m, 2H), 8.74 (s, 2H), 10.05 (s, 1H); ¹⁹F NMR (376 MHz, DMSO-d₆, 300 K): (major rotamer) δ −126.84, −175.97 ppm. LC (method A): t_(R)=1.85 min. LC/MS (EI) m/z: [M+H]⁺ 596.

Step 1: 2-(4-Bromo-3-carbamoyl-1H-pyrazol-1-yl)acetic acid (77a)

tert-Butyl 2-(4-bromo-3-carbamoyl-1H-pyrazol-1-yl)acetate 110b (120 mg, 0.40 mmol) in DCM (5 mL) was treated with TFA (5 mL) in a similar manner to that described in Step 2 of Scheme 7. The volatiles were removed under reduced pressure and the remaining material was used directly in the next synthetic step.

Step 2: (1R,3S,5R)-2-(2-(4-Bromo-3-carbamoyl-1H-pyrazol-1-yl)acetyl)-N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-2-azabicyclo[3.1.0]hexane-3-carboxamide (77)

The title compound 77 (50 mg) was prepared from 2-(4-bromo-3-carbamoyl-1H-pyrazol-1-yl)acetic acid 77a and (1R,3S,5R)—N-(2′-chloro-2-fluoro-[1,1′-biphenyl]-3-yl)-2-azabicyclo[3.1.0]hexane-3-carboxamide hydrochloride (131 mg) in a manner similar to that described in Scheme 5. ¹H NMR (400 MHz, DMSO-d₆, 300 K): (major rotamer) δ 0.65 (d, J=1.6 Hz, 1H), 0.97-1.02 (m, 1H), 1.86-1.88 (m, 1H), 2.24-2.29 (m, 2H), 3.66 (t, J=5.2 Hz, 1H), 4.52-4.56 (m, 1H), 5.19-5.47 (m, 2H), 7.09 (t, J=7.2 Hz, 1H), 7.24 (t, J=8.0 Hz, 1H), 7.28 (s, 1H), 7.39-7.47 (m, 4H), 7.59-7.61 (m, 1H), 7.94 (t, J=7.2 Hz, 1H), 7.99 (s, 1H), 9.79 (s, 1H); ¹⁹F NMR (376 MHz, DMSO-d₆, 300 K): (major rotamer) δ −126.64. LC (method A): t_(R)=1.97 min. LC/MS (EI) m/z: [M+H]⁺ 560.

Step 1: 2-Fluoro-3-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-2-yl)aniline (80b)

A solution of 3-bromo-2-fluoroaniline (0.5 g, 2.63 mmol), 4,4,4′,4′,5,5,5′,5′-octamethyl-2,2′-bi(1,3,2-dioxaborolane) (1.67 g, 6.6 mmol), and KOAc (0.77 g) in dioxane (10 mL) was degassed and refilled with argon twice. To this solution was added Pd(dppf)₂Cl₂ (289 mg) under an atmosphere of argon. The solution was heated at 90° C. for 15 h. The reaction mixture was cooled to rt and the volatiles were removed under reduced pressure. The remaining residue was purified by column chromatography to afford 80b (803 mg).

Step 2: 2′-Chloro-2,4′,5′-trifluoro-[1,1′-biphenyl]-3-amine hydrochloride (80c)

A solution of 2-fluoro-3-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-2-yl)aniline 80b (26.0 g, 110 mmol), 1-bromo-2,4,5-trifluorobenzene (12.5 g, 60 mmol), and K₂CO₃ (38 g, 275 mmol) in co-solvent of dioxane (250 mL) and water (63 mL) was degassed and refilled with argon twice. To this solution was added Pd(dppf)₂Cl₂ (8.04 g) under an atmosphere of argon. The solution was refluxed for 15 h. The reaction mixture was cooled to rt and the volatiles were removed under reduced pressure. The remaining residue was purified by column chromatography. The desired product fractions were collected and concentrated, and then the HCl salt 80c was made by treatment with HCl/MeOH. 13.1 g of 80c was obtained.

Step 3: (2S,4R)-tert-Butyl 2-((2′-chloro-2,4′,5′-trifluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate (80d)

To an ice-cold solution of (2S,4R)-1-(tert-butoxycarbonyl)-4-fluoropyrrolidine-2-carboxylic acid (9.5 g, 40.7 mmol) in DCM (200 mL) was added 1-chloro-N,N,2-trimethyl-1-propenylamine (5.92 mL, 1.1 equiv) dropwise with stirring. The stirring was continued for 3 h at this temperature, and then solid 2′-chloro-2,4′,5′-trifluoro-[1,1′-biphenyl]-3-amine hydrochloride 80c (13.1 g, 44.5 mmol) was added, followed by DIEA (21.3 mL). The cooling bath was removed and the reaction mixture was stirred overnight at rt. The reaction mixture was then added to water (120 mL) and extracted with DCM (2×120 mL). The organic layer was washed successively with an aq solution of NaHCO₃ (20 mL), water (20 mL), and brine (20 mL), and then dried over Na₂SO₄ and concentrated under reduced pressure. The remaining residue was purified by column chromatography (eluted with hexanes/EtOAc) to give 14.1 g of the desire title compound 80d.

Step 4: (2S,4R)—N-(2′-Chloro-2,4′,5′-trifluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamide hydrochloride (80e)

(2S,4R)-tert-Butyl 2-((2′-chloro-2,4′,5′-trifluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidine-1-carboxylate 80d (1.0 g) was taken in 4 N HCl in dioxane (10 mL) and the resulting reaction mixture was stirred at rt for 2 h. The solvent was then removed under reduced pressure and the remaining residue 80e was used directly without further purification.

Step 5: tert-Butyl 2-(3-carbamoyl-1H-indazol-1-yl)acetate (80g)

1H-Indazole-3-carboxamide 80f (56 g, 347 mmol) was dissolved in CH₃CN (500 mL). To this solution were added tert-butyl 2-bromoacetate (82 g, 61.5 mL) and potassium carbonate (77.4 g, 560 mmol). The mixture was heated at 90° C. for 3 h under an atmosphere of argon. The reaction mixture was cooled to rt and filtered through a pad of Celite®. The solid cake was washed with CH₃CN (120 mL), and the combined filtrate was concentrated under reduced pressure. The remaining residue was purified by column chromatography to afford the title compound 80g (70 g).

Step 6: 2-(3-Carbamoyl-1H-indazol-1-yl)acetic acid (80h)

tert-Butyl 2-(3-carbamoyl-1H-indazol-1-yl)acetate 80g (1.0 g) was taken in 4 N HCl in dioxane (10 mL) and the resulting reaction mixture was stirred at rt for 2 h. The solvent was then removed under reduced pressure and the remaining residue 80h was used directly without further purification.

Step 7: 1-(2-((2S,4R)-2-((2′-Chloro-2,4′,5′-trifluoro-[1,1′-biphenyl]-3-yl)carbamoyl)-4-fluoropyrrolidin-1-yl)-2-oxoethyl)-1H-indazole-3-carboxamide (80)

To a solution of 2-(3-carbamoyl-1H-indazol-1-yl)acetic acid 80h (5.3 g, 24.2 mmol), (2S,4R)—N-(2′-chloro-2,4′,5′-trifluoro-[1,1′-biphenyl]-3-yl)-4-fluoropyrrolidine-2-carboxamide hydrochloride 80e (9.0 g, 22.0 mmol) in DMF (50 mL) was added HATU (10 g) followed by dropwise addition of DIEA (18.0 mL) at rt. The mixture was stirred for 1 h at rt and the volatiles were removed under reduced pressure. The remaining residue was diluted with 10% aq sodium carbonate (50 mL) and extracted with ethyl acetate. The organic extract was washed with water and brine, then dried over MgSO₄. The solution was filtered and the filtrate was evaporated under reduced pressure. The remaining residue was purified by column chromatography to afford the title compound 80 (10.0 g). ¹H NMR (400 MHz, DMSO-d₆, 300 K): (major rotamer) δ 2.13-2.26 (m, 1H), 2.45-2.57 (m, 1H), 3.88-4.00 (m, 1H), 4.18-4.27 (m, 1H), 4.76 (t, J=8.4 Hz, 1H), 5.43-5.68 (m, 3H), 7.07-7.09 (m, 1H), 7.20-7.27 (m, 2H), 7.35-7.42 (m, 2H), 7.59-7.64 (m, 2H), 7.85-7.89 (m, 1H), 7.91-7.99 (m, 1H), 8.17 (d, J=8.4 Hz, 1H), 10.00 (s, 1H). ¹⁹F NMR (376 MHz, DMSO-d₆, 300K): (major rotamer) δ −126.7, −135.8, −139.4, −175.9. LC (method A): t_(R)=2.28 min. LC/MS (EI) m/z: [M+H]⁺ 574.

Example 7 Non-Limiting Examples of Compounds of Formula I

Table 1 shows illustrative compounds of Formula I with characterizing data. The assay of Example 8 was used to determine the IC₅₀'s of the compounds. Other standard factor D inhibition assays are also available. Three ***s are used to denote compounds with an IC₅₀ less than 1 micromolar; two **s indicate compound with an IC₅₀ between 1 micromolar and 10 micromolar, and one * denotes compounds with an IC₅₀ greater than 10 micromolar.

TABLE 1 RT min Cmp (Method MS No. Structure Name IC₅₀ A or B) (M + 1) 1

(25,3a5,7a5)-1-(2-(3- acetyl-1H-indol-1- yl)acetyl)-N-(3-chloro- 2- fluorobenzyl)octahydro- 1H-indole-2- carboxamide *** 2.33 (A) 510 2

(S)-N1-(1-carbamoyl- 1H-indol-3-yl)-N2-(3- chloro-2- fluorobenzyl)indoline- 1,2-dicarboxamide ** 2.04 (A) 506 3

(2S,4R)-N2-(1-acetyl- 1H-indol-3-yl)-N1-(3- chloro-2-fluorobenzyl)- 4-fluoropyrrolidine-1,2- dicarboxamide * 2.07 (A) 475 4

(2S,4S)-N2-(1-acetyl- 1H-indol-3-yl)-N1-(3- chloro-2-fluorobenzyl)- 4-fluoropyrrolidine-1,2- dicarboxamide * 2.05 (A) 475 5

(2S,4S)-N2-(1-acetyl- 1H-indol-3-yl)-N1- benzyl-4- fluoropyrrolidine-1,2- dicarboxamide * 1.78 (A) 423 6

(2S,4R)-N1-(1- carbamoyl-1H-indol-3- yl)-N2-(3-chloro-2- fluorophenylsulfonyl)- 4-fluoropyrrolidine-1,2- dicarboxamide * 1.33 (A) 526 7

(2S,4R)-N1-(1-acetyl- 1H-indol-3-yl)-N2-(3- chloro-2- fluorophenylsulfonyl)- 4-fluoropyrrolidine-1,2- dicarboxamide * 1.67 (A) 525 8

(R)-N2-(1-acetyl-1H- indol-3-yl)-N1-(3- chloro-2-fluorobenzyl)- 4,4-difluoropyrrolidine- 1,2-dicarboxamide * 2.25 (A) 493 9

(R)-N2-(1-acetyl-1H- indol-3-yl)-N1-(3- chloro-2- fluorobenzyl)pyrrolidine- 1,2-dicarboxamide * 2.14 (A) 457 10

3-((2S,4R)-2-(5-(3- chlorophenyl)-1H- imidazol-2-yl)-4- fluoropyrrolidine-1- carboxamido)-1H- indole-1-carboxamide ** 1.49 (A) 467 11

2-(3-acetyl-1H-indol-1- yl)-1-((2S,4R)-2-(5-(3- chlorophenyl)-1H- imidazol-2-yl)-4- fluoropyrrolidin-1- yl)ethanone * 1.46 (A) 465 12

3-((2S,4R)-2-(5-(6- bromopyridin-2-yl)-1H- imidazol-2-yl)-4- fluoropyrrolidine-1- carboxamido)-1H- indole-1-carboxamide ** 1.34 (A) 512 13

2-(3-acetyl-1H-indol-1- yl)-1-((2S,4R)-2-(5-(6- bromopyridin-2-yl)-1H- imidazol-2-yl)-4- fluoropyrrolidin-1- yl)ethanone ** 1.43 (A) 510 14

3-((2S,4R)-2-(5-chloro- 1H-benzo[d]imidazol-2- yl)-4-fluoropyrrolidine- 1-carboxamido)-1H- indole-1-carboxamide ** 1.42 (A) 441 15

2-(3-acetyl-1H-indol-1- yl)-1-((2S,4R)-2-(5- chloro-1H- benzo[d]imidazol-2-yl)- 4-fluoropyrrolidin-1- yl)ethanone * 1.54 (A) 439 16

(R)-N2-(1-acetyl-1H- indol-3-yl)-N1-(2- fluoro-3- (trifluoromethoxy)phenyl) pyrrolidine-1,2- dicarboxamide * 2.30 (A) 493 17

(R)-N-(1-acetyl-1H- indol-3-yl)-1-(2-(3- chloro-2- fluorophenyl)acetyl)- 4,4-difluoropyrrolidine- 2-carboxamide * 2.28 (A) 478 18

(2S,3R)-1-(2-(3-acetyl- 1H-indol-1-yl)acetyl)- N-(3-chloro-2- fluorobenzyl)-3- (cyclopropylmethoxy) pyrrolidine-2- carboxamide *** 2.12 (A) 526 19

(2S,4R)-N1-(1-acetyl- 1H-indol-3-yl)-N2-(3- chloro-2-fluorobenzyl)- 4-(7-methoxy-2- phenylquinolin-4- yloxy)pyrrolidine-1,2- dicarboxamide * 2.10 (A) 706 20

1,3-bis(1-acetyl-1H- indol-3-yl)urea * 1.98 (A) 375 21

(2S,3S,4S)-1-(2-(3- acetyl-6-hydroxy-1H- indol-1-yl)acetyl)-N-(3- chloro-2-fluorobenzyl)- 3- (cyclopropylmethoxy)- 4-fluoropyrrolidine-2- carboxamide *** 1.91 (A) 560 22

(1R,3S,5R)-N-(3- chloro-2-fluorobenzyl)- 2-(2-(3- (cyclopropanecarbonyl)- 1H-indol-1-yl)acetyl)- 2- azabicyclo[3.1.0]hexane- 3-carboxamide *** 2.07 (A) 494 23

(1R,2R)-N1-(1- carbamoyl-1H-indol-3- yl)-N2-(3-chloro-2- fluorobenzyl)cyclopentane- 1,2-dicarboxamide ** 1.87 (A) 457 24

(2S,4R)-N-(3-chloro-2- fluorobenzyl)-1-(2-(3- (cyclopropanecarbonyl)- 1H-indol-1-yl)acetyl)- 4-fluoropyrrolidine-2- carboxamide *** 2.02 (A) 500 25

(2S)-1-(2-(3-acetyl-6- hydroxy-1H-indol-1- yl)acetyl)-N-(3-chloro- 2-fluorobenzyl)-3- (cyclopropylmethoxy)- 4-fluoropyrrolidine-2- carboxamide *** 1.82 (A) 560 26

(1R,2R)-N1-(1- carbamoylindolin-3-yl)- N2-(3-chloro-2- fluorobenzyl)cyclopentane- 1,2-dicarboxamide * 1.35 (A) 459 27

2-(3-acetyl-1H-indol-1- yl)-1-((2S,4R)-4-fluoro- 2-((4-(4-fluorophenyl)- 1H-1,2,3-triazol-1- yl)methyl)pyrrolidin-1- yl)ethanone * 1.72 (A) 464 28

3-((2S,4R)-4-fluoro-2- ((4-(4-fluorophenyl)- 1H-1,2,3-triazol-1- yl)methyl)pyrrolidine-1- carboxamido)-1H- indole-1-carboxamide * 1.60 (A) 466 29

(2S,4R)-1-(2-(3-acetyl- 1H-indol-1-yl)acetyl)- N-(3-chloro-2- fluorobenzyl)-4-(7- methoxy-2- phenylquinolin-4- yloxy)pyrrolidine-2- carboxamide * 2.00 (A) 705 30

(2S,4R)-2-((4-(3- chloro-4-fluorophenyl)- 1H-1,2,3-triazol-1- yl)methyl)-4- fluoropyrrolidine-1- carboxamide * 1.15 (A) 342 31

N1-(1-carbamoyl-1H- indol-3-yl)-N2-(3- chloro-2- fluorobenzyl)cyclopent- 1-ene-1,2- dicarboxamide * 1.97 (A) 455 32

(2S,4R)-N-(3-chloro-2- fluorobenzyl)-1-(2-(3- (1-(cyanoimino)ethyl)- 1H-indol-1-yl)acetyl)-4- fluoropyrrolidine-2- carboxamide ** 1.48 (A) 498 33

2-(3-acetyl-1H-indol-1- yl)-1-((2S,4R)-4-fluoro- 2-(isoindoline-2- carbonyl)pyrrolidin-1- yl)ethanone * 0.95 (A) 434 34

(2S,4R)-1-(2-(3-acetyl- 1H-indol-1-yl)acetyl)- N-(3-chloro-2- fluorobenzyl)-4-fluoro- N-methylpyrrolidine-2- carboxamide * 1.35 (A) 488 35

(2S,3aS,7aS)-1-(2-(3- acetyl-6-hydroxy-1H- indol-1-yl)acetyl)-N-(3- chloro-2- fluorobenzyl)octahydro- 1H-indole-2- carboxamide *** 1.30 (A) 526 36

(2S,4R)-N-(3-chloro-2- fluorobenzyl)-1-(2-(3- cyano-1H-indol-1- yl)acetyl)-4- fluoropyrrolidine-2- carboxamide *** 1.38 (A) 457 37

(2S,4R)-N-(3-chloro-2- fluorobenzyl)-4-fluoro- 1-(2-(4-oxo-3,4- dihydro-1H-carbazol- 9(2H)- yl)acetyl)pyrrolidine-2- carboxamide *** 1.18 (A) 500 38

tert-butyl (S)-1- ((2S,4R)-2-(3-chloro-2- fluorobenzylcarbamoyl)- 4-fluoropyrrolidin-1- yl)-3-(1H-indol-3-yl)-1- oxopropan-2- ylcarbamate * 1.66 (A) 561 39

(2S,4R)-1-((S)-2- amino-3-(1H-indol-3- yl)propanoyl)-N-(3- chloro-2-fluorobenzyl)- 4-fluoropyrrolidine-2- carboxamide * 0.40 (A) 461 40

2-(3-acetyl-6-hydroxy- 1H-indol-1-yl)-1- ((2S,4R)-2-(5-(6- bromopyridin-2-yl)-1H- imidazol-2-yl)-4- fluoropyrrolidin-1- yl)ethanone ** 0.93 (A) 526 41

(S)-7-(2-(3-acetyl-6- hydroxy-1H-indol-1- yl)acetyl)-N-(2-fluoro- 3- (trifluoromethoxy)phenyl)- 1,4-dioxa-7- azaspiro[4.4]nonane-8- carboxamide ** 1.21 (A) 566 42

(2S,4R)-1-(2-(3-acetyl- 1H-indol-1-yl)acetyl)- N-(2,3-dihydro-1H- inden-1-yl)-4- fluoropyrrolidine-2- carboxamide ** 1.06 (A) 448 43

(2S,4R)-1-(2-(3-acetyl- 1H-indol-1-yl)acetyl)- N-(2,3-dihydro-1H- inden-2-yl)-4- fluoropyrrolidine-2- carboxamide *** 1.05 (A) 448 44

(2S,4R)-1-(2-(3-acetyl- 1H-indol-1-yl)acetyl)- N-(4-chloro-2,3- dihydro-1H-inden-1-yl)- 4-fluoropyrrolidine-2- carboxamide ** 1.15 (A) 482 45

(2S,4R)-1-(2-(3-acetyl- 1H-pyrazolo[3,4- c]pyridin-1-yl)acetyl)-4- fluoro-N-(3- (trifluoromethylthio) phenyl)pyrrolidine-2- carboxamide *** 1.16 (A) 511 46

(2S,4R)-N-(3-chloro-2- fluorobenzyl)-4-fluoro- 1-(2-(3-nitro-1H-indol- 1-yl)acetyl)pyrrolidine- 2-carboxamide *** 1.37 (A) 477 47

(2S,4R)-1-(2-(3- acetamido-1H-indol-1- yl)acetyl)-N-(3-chloro- 2-fluorobenzyl)-4- fluoropyrrolidine-2- carboxamide *** 1.01 (A) 489 48

(2S,4R)-1-(2-(3-acetyl- 6-hydroxy-1H-indol-1- yl)acetyl)-4-fluoro-N- (3- (trifluoromethylthio) phenyl)pyrrolidine-2- carboxamide *** 1.09 (A) 524 49

(2S,4R)-N-(3-chloro-2- fluorobenzyl)-1-(2-(1,1- dioxido-2H- benzo[e][1,2,4]thiadiazin- 3-yl)acetyl)-4- fluoropyrrolidine-2- carboxamide ** 0.86 (A) 497 50

(2S,4R)-N-(3-chloro-2- fluorobenzyl)-4-fluoro- 1-(2-(pyridin-3- yl)thiazole-4- carbonyl)pyrrolidine-2- carboxamide * 0.77 (A) 463 51

(2S,4R)-1-(6- acetamidonicotinoyl)- N-(3-chloro-2- fluorobenzyl)-4- fluoropyrrolidine-2- carboxamide * 0.55 (A) 437 52

(2S,4R)-N-(3-chloro-2- fluorobenzyl)-4-fluoro- 1-(2-(3-iodo-1H- pyrazolo[3,4-c]pyridin- 1-yl)acetyl)pyrrolidine- 2-carboxamide *** 1.00 (A) 560 53

diethyl 1-(2-((2S,4R)-2- (3-chloro-2- fluorobenzylcarbamoyl)- 4-fluoropyrrolidin-1- yl)-2-oxoethyl)-1H- pyrazolo[3,4-c]pyridin- 3-ylphosphonate ** 0.82 (A) 570 54

(2S,4R)-N2-(3-chloro- 2-fluorobenzyl)-N1-(1- (cyclopropanecarbonyl)- 1H-indol-3-yl)-4- fluoropyrrolidine-1,2- dicarboxamide *** 1.28 (A) 501 55

(2S,4R)-1-(2-(3-acetyl- 1H-indol-1- yl)propanoyl)-N-(3- chloro-2-fluorobenzyl)- 4-fluoropyrrolidine-2- carboxamide * 1.17 (A) 488 56

(2S,4R)-1-(2-(3-acetyl- 1H-indol-1-yl)-2- methylpropanoyl)-N-(3- chloro-2-fluorobenzyl)- 4-fluoropyrrolidine-2- carboxamide * 1.96 (A) 502 57

1-(2-((2S,4R)-2-(3- chloro-2- fluorobenzylcarbamoyl)- 4-fluoropyrrolidin-1- yl)-2-oxoethyl)-1H- pyrazolo[3,4-c]pyridin- 3-ylphosphonic acid * 0.72 (A) 514 58

(2S,4R)-1-(2-(4- acetylnaphthalen-1- yl)acetyl)-N-(3-chloro- 2-fluorobenzyl)-4- fluoropyrrolidine-2- carboxamide ** 2.04 (A) 485 59

diethyl 3-((2S,4R)-1-(2- (3-acetyl-1H-indol-1- yl)acetyl)-4- fluoropyrrolidine-2- carboxamido)-5- chlorophenylphosphonate ** 1.89 (A) 578 60

ethyl hydrogen 1-(2- ((2S,4R)-2-(3-chloro-2- fluorobenzylcarbamoyl)- 4-fluoropyrrolidin-1- yl)-2-oxoethyl)-1H- pyrazolo[3,4-c]pyridin- 3-ylphosphonate ** 0.86 (A) 542 61

diethyl 3-(((2S,4R)-1- (2-(3-acetyl-1H-indol-1- yl)acetyl)-4- fluoropyrrolidine-2- carboxamido)methyl)-5- chloro-4- fluorophenylphosphonate *** 1.82 (A) 610 62

(2S,3aR,6aR)-1-(2-(3- acetyl-6-hydroxy-1H- indol-1-yl)acetyl)-N-(3- chloro-2- fluorobenzyl)octahydro cyclopenta[b]pyrrole-2- carboxamide *** 1.88 (A) 512 63

3-(((2S,4R)-1-(2-(3- acetyl-1H-indol-1- yl)acetyl)-4- fluoropyrrolidine-2- carboxamido)methyl)-5- chloro-4- fluorophenylphosphonic acid *** 0.98 (A) 554 64

(2S,4R)-1-(2-(3-acetyl- 6-hydroxy-1H-indol-1- yl)acetyl)-N-((1R,2S)- 1- (cyclopropylsulfonyl- carbamoyl)-2- vinylcyclopropyl)-4- fluoropyrrolidine-2- carboxamide ** 1.16 (A) 561 65

(2S,4R)-N-(3-chloro-2- fluorobenzyl)-1-(2-(1,1- dioxido-4H- benzo[e][1,2,4]thiadiazin- 4-yl)acetyl)-4- fluoropyrrolidine-2- carboxamide * 1.25 (A) 497 66

(2S,3aR,7aR)-1-(2-(3- acetyl-6-hydroxy-1H- indol-1-yl)acetyl)-N-(3- chloro-2- fluorobenzyl)octahydro- 1H-indole-2- carboxamide ** 1.93 (A) 526 67

tert-butyl 9-(2-((2S,4R)- 2-(3-chloro-2- fluorobenzylcarbamoyl)- 4-fluoropyrrolidin-1- yl)-2-oxoethyl)-3,4- dihydro-1H-pyrido[3,4- b]indole-2(9H)- carboxylate * 2.71 (A) 587 68

(2S,4R)-N-(3-chloro-2- fluorobenzyl)-1-(2-(3,4- dihydro-1H-pyrido[3,4- b]indol-9(2H)- yl)acetyl)-4- fluoropyrrolidine-2- carboxamide * 1.38 (A) 487 69

(2S,4R)-N-(3-chloro-2- fluorobenzyl)-4-fluoro- 1-(2-(2- (methylsulfonyl)-3,4- dihydro-1H-pyrido[3,4- b]indol-9(2H)- yl)acetyl)pyrrolidine-2- carboxamide ** 2.06 (A) 565 70

ethyl 3-(9-(2-((2S,4R)- 2-(3-chloro-2- fluorobenzylcarbamoyl)- 4-fluoropyrrolidin-1- yl)-2-oxoethyl)-3,4- dihydro-1H-pyrido[3,4- b]indol-2(9H)-yl)-3- oxopropanoate * 2.16 (A) 601 71

(2S,4R)-1-(2-(1-acetyl- 1H-indol-3-yl)-2- oxoacetyl)-N-(3-chloro- 2-fluorobenzyl)-4- fluoropyrrolidine-2- carboxamide * 2.31 (A) 488 72

4-(9-(2-((2S,4R)-2-(3- chloro-2- fluorobenzylcarbamoyl)- 4-fluoropyrrolidin-1- yl)-2-oxoethyl)-3,4- dihydro-1H-pyrido[3,4- b]indol-2(9H)-yl)-4- oxobutanoic acid * 1.88 (A) 587 73

(2S,4R)-1-(2-(3-(1H- pyrazol-4-yl)-1H- pyrazolo[3,4-c]pyridin- 1-yl)acetyl)-N-(3- chloro-2-fluorobenzyl)- 4-fluoropyrrolidine-2- carboxamide *** 1.00 (A) 500 74

(2S,4R)-N-(3-chloro-2- fluorobenzyl)-4-fluoro- 1-(2-(3-(1-fluorovinyl)- 1H-pyrazolo[3,4- c]pyridin-1- yl)acetyl)pyrrolidine-2- carboxamide *** 1.61 (A) 478 75

(2S,4R)-1-(2-(3-(1H- imidazol-5-yl)-1H- pyrazolo[3,4-c]pyridin- 1-yl)acetyl)-N-(3- chloro-2-fluorobenzyl)- 4-fluoropyrrolidine-2- carboxamide *** 0.84 (A) 500 76

(2S,4R)-N-(3-chloro-2- fluorobenzyl)-4-fluoro- 1-(2-(3-sulfamoyl-1H- indol-1- yl)acetyl)pyrrolidine-2- carboxamide *** 1.62 (A) 511 77

(1R,3S,5R)-2-(2-(4- bromo-3-carbamoyl- 1H-pyrazol-1- yl)acetyl)-N-(2′-chloro- 2-fluorobiphenyl-3-yl)- 2- azabicyclo[3.1.0]hexane- 3-carboxamide *** 1.97 (A) 560 78

(2S,4R)-1-(2-(3-(1- amino-2,2,2- trifluoroethyl)-1H- indol-1-yl)acetyl)-N-(3- chloro-2-fluorobenzyl)- 4-fluoropyrrolidine-2- carboxamide ** 1.45 (A) 531 79

(2S,4R)-1-(2-(3-acetyl- 7-cyano-1H-indol-1- yl)acetyl)-N-(2′-chloro- 2-fluorobiphenyl-3-yl)- 4-fluoropyrrolidine-2- carboxamide *** 2.41 (A) 561 80

1-(2-((2S,4R)-2-(2′- chloro-2,4′,5′- trifluorobiphenyl-3- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H- indazole-3-carboxamide *** 2.28 (A) 574 81

(2S,4R)-1-(2-(3-acetyl- 5-(1-(1,3- dioxoisoindolin-2- yl)cyclopropyl)-1H- indol-1-yl)acetyl)-N-(6- bromopyridin-2-yl)-4- fluoropyrrolidine-2- carboxamide *** 2.17 (A) 674 82

(2S,4R)-1-(2-(3-acetyl- 1H-indol-1-yl)acetyl)- N-(2′-chloro-2,4′,5′- trifluorobiphenyl-3-yl)- 4-fluoropyrrolidine-2- carboxamide *** 2.87 (A) 572 83

1-(2-((2S,4R)-2-(2′- chloro-2,4′,5′- trifluorobiphenyl-3- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H- pyrazolo[3,4- c]pyridine-3- carboxamide *** 2.26 (A) 575 84

2-(3-acetyl-1H-indol-1- yl)-1-(4-(2,3,4- trimethoxybenzyl) piperazin- 1-yl)ethanone 85

(R)-3-(1-benzyl-1H- indole-3-carbonyl)-N- isobutylthiazolidine-4- carboxamide 86

2-(3-acetyl-1H-indol-1- yl)-1-(4- benzylpiperazin-1- yl)ethanone 87

methyl 1-(2- ((benzo[d][1,3]dioxol- 5- ylmethyl)(cyclopentyl) amino)-2-oxoethyl)-1H- indole-3-carboxylate 88

(S)-2-(1-(2-(3-acetyl- 1H-indol-1- yl)acetyl)piperidin-3- yl)-1H-imidazol-3-ium 89

(S)-methyl 1-(2-(2-(4- methoxyphenyl)azepan- 1-yl)-2-oxoethyl)-1H- indole-3-carboxylate 90

(2S,4R)-1-(2-(6-acetyl- 6H-thieno[2,3-b]pyrrol- 4-yl)acetyl)-N-(2′- chloro-2- fluorobiphenyl-3-yl)-4- fluoropyrrolidine-2- carboxamide *** 2.68 (A) 542 91

(2S,4R)-1-(2-(4- acetamido-3-acetyl-1H- indol-1-yl)acetyl)-N-(2′- chloro-2- fluorobiphenyl-3-yl)-4- fluoropyrrolidine-2- carboxamide * 2.16 (A) 593 92

1-(2-((2S,4R)-2-(2′- chloro-2,3′,4′- trifluorobiphenyl-3- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H- indazole-3-carboxamide *** 2.68 (A) 574 93

(2S,4R)-1-(2-(3-acetyl- 1H-indol-1-yl)acetyl)- N-(2′-chloro-2,3′,4′- trifluorobiphenyl-3-yl)- 4-fluoropyrrolidine-2- carboxamide *** 2.88 (A) 572 94

1-(2-((2S,4R)-2-(2′- chloro-2,3′,5′- trifluorobiphenyl-3- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H- indazole-3-carboxamide *** 2.82 (A) 574 95

(2S,4R)-1-(2-(3-acetyl- 1H-indol-1-yl)acetyl)- N-(2′-chloro-2,3′,5′- trifluorobiphenyl-3-yl)- 4-fluoropyrrolidine-2- carboxamide *** 3.06 (A) 572 96

(2S,4R)-1-(2-(3-acetyl- 4-methoxy-1H-indol-1- yl)acetyl)-N-(2′-chloro- 2-fluorobiphenyl-3-yl)- 4-fluoropyrrolidine-2- carboxamide ** 2.28 (A) 566 97

(2S,4R)-1-(2-(3-acetyl- 4-cyano-1H-indol-1- yl)acetyl)-N-(2′-chloro- 2-fluorobiphenyl-3-yl)- 4-fluoropyrrolidine-2- carboxamide *** 2.13 (A) 561 98

6-(2-((2S,4R)-2-(2′- chloro-2- fluorobiphenyl-3- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-6H- thieno[2,3-b]pyrrole-4- carboxamide *** 2.52 (A) 543 99

1-(2-((2S,4R)-2-(2′- chloro-2- fluorobiphenyl-3- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H- thieno[3,2-c]pyrazole-3- carboxamide *** 1.94 (A) 544 100

1-(2-((2S,4R)-2-(6-(2- chloro-4,6- difluorophenyl)pyridin- 2-ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H- pyrazolo[3,4- c]pyridine-3- carboxamide *** 1.55 (A) 558 101

1-(2-((2S,4R)-2-(2′- chloro-4′,6′- difluorobiphenyl-3- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H- pyrazolo[3,4- c]pyridine-3- carboxamide *** 1.73 (A) 557 103

4-(2-((2S,4R)-2-(2′- chloro-2- fluorobiphenyl-3- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-4H- thieno[3,2-b]pyrrole-6- carboxamide *** 1.94 (A) 544 104

1-(2-((2S,4R)-2-(2′- chloro-2- fluorobiphenyl-3- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-4,5,6,7- tetrahydro-1H-indazole- 3-carboxamide *** 2.02 (A) 542 105

1-(2-((2S,4R)-2-(6- bromopyridin-2- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-7-(3- chlorophenyl)-1,5a- dihydroimidazo[4,5- g]indazole-3- carboxamide *** 2.60 (A) 640 106

1-(2-((2S,4R)-2-(6- bromopyridin-2- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H- thieno[3,2-c]pyrazole-3- carboxamide *** 1.33 (A) 497 107

1-(2-((1R,3S,5R)-3-(3- chloro-2- fluorobenzylcarbamoyl)- 2- azabicyclo[3.1.0]hexan- 2-yl)-2-oxoethyl)-1H- thieno[3,2-c]pyrazole-3- carboxamide *** 1.49 (A) 476 110

1-(2-((2S,4R)-2-(2′- chloro-2- fluorobiphenyl-3- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-4-(2- methoxypyrimidin-5- yl)-1H-pyrazole-3- carboxamide * 1.85 (A) 596 111

1-(2-((2S,4R)-2-(2′- chloro-2- fluorobiphenyl-3- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-7-cyano- 1H-indazole-3- carboxamide *** 2.09 (A) 563 112

(2S,4R)-1-(2-(3-acetyl- 7-(6-chloropyridin-3- yl)-1H-indol-1- yl)acetyl)-N-(2′-chloro- 2-fluorobiphenyl-3-yl)- 4-fluoropyrrolidine-2- carboxamide *** 2.66 (A) 647 113

1-(2-((2S,4R)-2-(2′- chloro-2- fluorobiphenyl-3- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-5-methyl- 1H-thieno[3,2- c]pyrazole-3- carboxamide *** 2.10 (A) 558 114

(2S,4R)-1-(2-(3-acetyl- 7-(1H-pyrazol-4-yl)- 1H-indol-1-yl)acetyl)- N-(2′-chloro-2- fluorobiphenyl-3-yl)-4- fluoropyrrolidine-2- carboxamide *** 2.12 (A) 602 115

(2S,4R)-1-(2-(3-acetyl- 7-cyclopropyl-1H- indol-1-yl)acetyl)-N-(2′- chloro-2- fluorobiphenyl-3-yl)-4- fluoropyrrolidine-2- carboxamide *** 2.59 (A) 576 117

1-(2-((2S,4R)-2-(5′- acetyl-2′-chloro-2- fluorobiphenyl-3- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H- indazole-3-carboxamide *** 1.92 (A) 580 118

1-(2-((2S,4R)-2-(6- bromopyridin-2- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-5-methyl- 1H-thieno[3,2- c]pyrazole-3- carboxamide *** 1.56 (A) 509 119

N-(1-(3-acetyl-1-(2- ((2S,4R)-2-(6- bromopyridin-2- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H-indol-5- yl)cyclopropyl)pyrimidine- 2-carboxamide *** 1.57 (A) 648 120

1-(2-((2S,4R)-2-(2′- chloro-2-fluoro-5′- (trifluoromethoxy)biphenyl- 3-ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H- indazole-3-carboxamide *** 2.42 (A) 622 121

1-(2-((2S,4R)-2-(5-(2- chlorophenyl)-1H- benzo[d]imidazol-2-yl)- 4-fluoropyrrolidin-1- yl)-2-oxoethyl)-1H- indole-3-carboxamide * 1.68 (A) 516 122

1-(2-((2S,4R)-2-(3-(4- chloro-1H- benzo[d]imidazol-5-yl)- 2- fluorophenylcarbamoyl)- 4-fluoropyrrolidin-1- yl)-2-oxoethyl)-1H- indazole-3-carboxamide *** 1.27 (A) 578 123

tert-butyl 1-(3-acetyl-1- (2-((2S,4R)-2-(6- bromopyridin-2- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H-indol-5- yl)cyclopropylcarbamate *** 2.20 (A) 644 124

(2S,4R)-1-(2-(3-acetyl- 7-((5-fluoropyrimidin- 2-yl)ethynyl)-1H-indol- 1-yl)acetyl)-N-(2′- chloro-2- fluorobiphenyl-3-yl)-4- fluoropyrrolidine-2- carboxamide *** 2.59 (A) 656 126

N-(1-(3-acetyl-1-(2- ((2S,4R)-2-(6- bromopyridin-2- ylcarbamoyl)-4- fluoropyrrolidin-1-yl)- 2-oxoethyl)-1H-indol-5- yl)cyclopropyl)pyrimidine- 5-carboxamide 1.55 (A) 649 127

(1R,3S,5R)-2-(2-(3- carbamoyl-1H- pyrazolo[3,4-c]pyridin- 1-yl)acetyl)-2- azabicyclo[3.1.0]hexane- 3-carboxammide, N-(3- chloro-2- fluorophenylmethyl-d₂) *** 1.07 (A) 473 128

(2S,4R)-1-(2-(3- carbamoyl-1H- pyrazolo[3,4-c]pyridin- 1-yl)acetyl)-4- fluoropyrrolidine-2- carboxamide, N-(3- chloro-2- fluorophenylmethyl-d₂) *** 0.86 (A) 479

Example 8 Human Factor D Assay

Human factor D (purified from human serum, Complement Technology, Inc.) at 80 nM final concentration is incubated with test compound at various concentrations for 5 minutes at room temperature in 50 mM Tris, 1M NaCl, pH 7.5. A synthetic substrate Z-L-Lys-SBzl and DTNB (Ellman's reagent) are added to final concentrations of 100 μM each. The increase in color is recorded at OD₄₀₅ nm in a microplate in kinetic mode over 30 minutes with 30 second time points in a spectrofluorimeter. IC₅₀ values are calculated by non-linear regression from the percentage of inhibition of complement factor D activity as a function of test compound concentration.

Example 9 Hemolysis Assay

The hemolysis assay was previously described by G. Ruiz-Gomez, et al., J. Med. Chem. (2009) 52: 6042-6052. In the assay red blood cells (RBC), rabbit erythrocyctes (purchased from Complement Technologies), are washed using GVB Buffer (0.1% gelatin, 5 mM Veronal, 145 mM NaCl, 0.025% NaN3, pH 7.3) plus 10 mM final Mg-EGTA. Cells are used at a concentration of 1×10⁸ cells/mL. Prior to the hemolysis assay, the optimum concentration of Normal Human Serum (NHS) needed to achieve 100% lysis of rabbit erythrocytes is determined by titration. NHS (Complement Technologies) is incubated with inhibitor for 15 min at 37° C., rabbit erythrocytes in buffer were added and incubated for an additional 30 min at 37° C. Positive control (100% lysis) consists of serum and RBC and negative control (0% lysis) of Mg-EGTA buffer and RBC only. Samples are centrifuged at 2000 g for 5 min, and supernatants collected. Optical density of the supernatant is monitored at 405 nm using a UV/visible spectrophotometer. Percentage lysis in each sample is calculated relative to positive control (100% lysis).

This specification has been described with reference to embodiments of the invention. However, one of ordinary skill in the art appreciates that various modifications and changes can be made without departing from the scope of the invention as set forth in the claims below. Accordingly, the specification is to be regarded in an illustrative rather than a restrictive sense, and all such modifications are intended to be included within the scope of invention. 

What is claimed is:
 1. A compound of the formula

or a pharmaceutically acceptable salt thereof, wherein Q¹ is N(R) or C(R¹R^(1′)); Q² is Q² is C(R²R^(2′)), C(R²R^(2′))—C(R²R^(2′)), S, O, N(R²) or C(R²R^(2′))O; Q³ is N(R³), S, or C(R³R^(3′)); (a) X¹ and X² are independently N or CH, or (b) X¹ and X² together are C═C; R¹, R^(1′), R², R^(2′), R³, and R^(3′) are independently chosen at each occurrence from (c) and (d) (c) hydrogen, halogen, hydroxyl, nitro, cyano, amino, C₁-C₆alkyl, C₂-C₆alkenyl, C₁-C₆alkoxy, C₂-C₆alkynyl, C₂-C₆alkanoyl, C₁-C₆thioalkyl, hydroxyC₁-C₆alkyl, aminoC₁-C₆alkyl, —C₀-C₄alkylNR⁹R¹⁰, —C(O)OR⁹, —OC(O)R⁹, —NR⁹C(O)R¹⁰, —C(O)NR⁹R¹⁰, —OC(O)NR⁹R¹⁰, —O(heteroaryl), —NR⁹C(O)OR¹⁰, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, R⁹ and R¹⁰ are independently chosen at each occurrence from hydrogen, C₁-C₆alkyl, and (C₃-C₇cycloalkyl)C₀-C₄alkyl; (d) —C₀-C₄alkyl(C₃-C₇cycloalkyl) and —O—C₀-C₄alkyl(C₃-C₇cycloalkyl); Additionally any one of the following rings (e), (f), (g), (h), (i), or (j) may be present: (e) R¹ and R^(1′) or R³ and R^(3′) may be taken together to form a 3- to 6-membered carbocyclic spiro ring or a 3- to 6-membered heterocyclic spiro ring containing 1 or 2 heteroatoms independently chosen from N, O, or S; (f) R² and R^(2′) may be taken together to form a 3- to 6-membered carbocyclic spiro ring, (g) R² and R^(2′) may be taken together to form a 3- to 6-membered heterocyclic spiro ring, each of which spiro rings (e), (f), and (g) is unsubstituted or substituted with one or more halogen or methyl substituents; (h) R¹ and R² may be taken together to form a 3-membered carbocyclic ring; or R¹ and R^(1′) or R² and R^(2′) are linked to form a carbonyl group; or R¹ and R² or R² and R³ can be taken together to form a carbon-carbon double bond; (i) R¹ and R² may be taken together to form a 4- to 6-membered carbocyclic ring or a 4- to 6-membered heterocyclic ring containing 1 or 2 heteroatoms independently chosen from N, O, and S; (j) R² and R³, if bound to adjacent carbon atoms, may be taken together to form a 3- to 6-membered carbocyclic ring or a 3- to 6-membered heterocyclic ring; each of which ring (h), (i), and (j) may be unsubstituted or substituted with 1 or more substituents independently chosen from halogen, hydroxyl, cyano, —COOH, C₁-C₄alkyl, C₂-C₄alkenyl, C₁-C₄alkoxy, C₂-C₄alkanoyl, hydroxyC₁-C₄alkyl, (mono- and di-C₁-C₄alkylamino)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —O—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; A is a group chosen from (k) and (l) where (k) is

and (l) is

X⁴ is B(OH) and Y is CHR⁹; or X⁴ is CHR⁹ and Y is B(OH); R¹⁰¹ is hydrogen, alkyl, carboxy; R⁴ is (m) or (n) (m) —CHO, —CONH₂, or C₂-C₆alkanoyl, including C(O)C₃-C₇cycloalkyl; (n) hydrogen, —SO₂NH₂, —C(CH₂)F, —CH(CF₃)NH₂, C₁-C₆alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C(O)C₀-C₂alkyl(C₃-C₇cycloalkyl),

each of which R⁴ other than hydrogen, —CHO, and —CONH₂, is unsubstituted or substituted with one or more of amino, imino, halogen, hydroxyl, cyano, cyanoimino, C₁-C₂alkyl, C₁-C₂alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R⁵ and R⁶ are independently chosen from (o) and (p) (o) —CHO, —C(O)NH₂, —C(O)NH(CH₃), or C₂-C₆alkanoyl; (p) hydrogen, hydroxyl, halogen, cyano, nitro, —COOH, —SO₂NH₂, —C(NH₂)C₁-C₃alkyl, —C(NH₂)C₁-C₃haloalkyl, —CF(C═CH₂), —C(═NCN)C₁-C₆alkyl, C₁-C₆alkyl, C₂-C₆alkenyl, C₁-C₆alkoxy, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C(O)C₀-C₄alkyl(C₃-C₇cycloalkyl), —P(O)(OR⁹)₂, —OC(O)R⁹, —C(O)OR⁹, —C(O)N(CH₂CH₂R⁹)(R¹⁰), —NR⁹C(O)R¹⁰, phenyl, or 5- to 6-membered heteroaryl. each R⁵ and R⁶ other than hydrogen, hydroxyl, cyano, and —COOH is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, amino, imino, cyano, cyanoimino, C₁-C₂alkyl, C₁-C₄alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₂haloalkyl, C₁-C₂haloalkoxy, C(O)alkyl, C(O)cycloalkyl, C(O)aryl, C(O)heterocycle, and C(O)heteroaryl. R^(6′) is hydrogen, halogen, hydroxyl, C₁-C₄alkyl, or C₁-C₄alkoxy; or R⁶ and R^(6′) may be taken together to form an oxo, vinyl, or imino group; R⁷ is hydrogen, C₁-C₆alkyl, or —C₀-C₄alkyl(C₃-C₇cycloalkyl); R⁸ and R^(8′) are independently chosen from hydrogen, halogen, hydroxyl, C₁-C₆alkyl, C₁-C₆alkoxy, and (C₁-C₄alkylamino)C₀-C₂alkyl, or R⁸ and R^(8′) are taken together to form an oxo group; R¹⁶ is 0 or 1 or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R¹⁹ is hydrogen, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, —SO₂C₁-C₆alkyl, (mono- and di-C₁-C₆alkylamino)C₁-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), each of which R¹⁹ other than hydrogen is substituted with 0 or 1 or more substituents independently chosen from halogen, hydroxyl, amino, —COOH, and —C(O)OC₁-C₄alkyl; X¹¹ is N or CR¹¹; X¹² is N or CR¹²; X¹³ is N or CR¹³; X¹⁴ is N or CR¹⁴; where no more than 2 of X¹¹, X¹², X¹³, and X¹⁴ are N; R¹¹, R¹⁴, and R¹⁵ are independently chosen at each occurrence from hydrogen, halogen, hydroxyl, nitro, cyano, —NR⁹C(O)R¹⁰, C(O)NR⁹R¹⁰, —O(PO)(OR⁹)₂, —(PO)(OR⁹)₂, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkenyl(aryl), C₂-C₆alkenyl(cycloalkyl), C₂-C₆alkenyl(heterocycle), C₂-C₆alkenyl(heteroaryl), C₂-C₆alkynyl, C₂-C₆alkynyl(aryl), C₂-C₆alkynyl(cycloalkyl), C₂-C₆alkynyl(heterocycle), C₂-C₆alkynyl(heteroaryl), C₂-C₆alkanoyl, C₁-C₆alkoxy, C₁-C₆thioalkyl, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl), (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S), —C₀-C₄alkoxy(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R¹² and R¹³ are independently chosen from (q), (r), and (s), (q) hydrogen, halogen, hydroxyl, nitro, cyano, amino, —COOH, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, (r) C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, C₂-C₆alkenyloxy, —C(O)OR⁹, C₁-C₆thioalkyl, —C₀-C₄alkylNR⁹R¹⁰, —C(O)NR⁹R¹⁰, —SO₂R⁹, —SO₂NR⁹R¹⁰, —OC(O)R⁹, and —C(NR⁹)NR⁹R¹⁰, each of which (r) is unsubstituted or substituted with one or more substituents independently selected from halogen, hydroxyl, nitro, cyano, amino, —COOH, —CONH₂C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, and each of which (r) is also optionally substituted with one substituent chosen from phenyl and 4- to 7-membered heterocycle containing 1, 2, or 3 heteroatoms independently chosen from N, O, and S; which phenyl or 4- to 7-membered heterocycle is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl)(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; (s) —C(CH₂)₂R³⁰; R³⁰ is —NR⁹C(O)R³¹ or R³²; R³¹ and R³² are C₁-C₆alkyl, C₁-C₆haloalkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S; L is either (t), (u), or (v) where (t) is a group of the formula

R¹⁷ is hydrogen or C₁-C₆alkyl and R¹⁸ and R^(18′) are independently chosen from hydrogen, halogen, and methyl; and m is 0, 1, 2, or 3; and (u) is a bond, (v) or a directly linked optionally substituted alkyl, alkyl(heteroaryl), heterocyclic aryl, heteroaryl, moiety including but not limited to:

B is a monocyclic or bicyclic carbocyclic or carbocyclic-oxy group or a monocyclic, bicyclic, or tricyclic heterocyclic group having 1, 2, 3, or 4 heteroatoms independently selected from N, O, and S and from 4 to 7 ring atoms per ring, or B is a C₂-C₆alkenyl or C₂-C₆alkynyl group; each of which B is unsubstituted or substituted with one or more substituents independently chosen from (w) and (x) and 0 or 1 substituents chosen from (y) and (z) (w) halogen, hydroxyl, —COOH, cyano, C₁-C₆alkyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkylNR⁹R¹⁰, —SO₂R⁹, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; (x) nitro, C₂-C₆alkenyl, C₂-C₆alkynyl, C₁-C₆thioalkyl, -JC₃-C₇cycloalkyl, —B(OH)₂, -JC(O)NR⁹R²³, -JOSO₂OR²¹, SR⁹, —C(O)(CH₂)₁₋₄S(O)R²¹, —O(CH₂)₁₋₄S(O)NR²¹R²², -JOP(O)(OR²¹)(OR²²), -JP(O)(OR²¹)(OR²²), -JOP(O)(OR²¹)R²², -JP(O)(OR²¹)R²², -JOP(O)R²¹R²², -JP(O)R²¹R²², -JSP(O)(OR²¹)(OR²²), -JSP(O)(OR²¹)(R²²), -JSP(O)(R²¹)(R²²), -JNR⁹P(O)(NHR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(OR²²), -JC(S)R²¹, -JNR²¹SO₂R²², -JNR⁹S(O)_(n)NR¹⁰R²², -JSO₂NR⁹COR²², -JSO₂NR⁹CONR²¹R²², -JNR²¹SO₂R²², -JC(O)NR²¹SO₂R²², -JC(NH₂)NR²², -JC(NH₂)NS(O)₂R²², -JOC(O)NR²¹R²², -JNR²¹C(O)OR²², -JNR²¹OC(O)R²², —(CH₂)₁₋₄C(O)NR²¹R²², -JC(O)R²⁴R²⁵, -JNR⁹C(O)R²¹, -JC(O)R²¹, -JNR⁹C(O)NR¹R²², —CCR²¹, —(CH₂)₁₋₄OC(O)R²¹, and -JC(O)OR²³; each of which (x) may be unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂, —P(O)(OH)₂, C₁-C₆alkyl, C₁-C₆alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₆alkylester, C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; (y) naphthyl, naphthyloxy, indanyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl containing 1 or 2 heteroatoms chosen from N, O, and S, and bicyclic heterocycle containing 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and containing 4- to 7-ring atoms in each ring; each of which (y) is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; and (z) tetrazolyl, (phenyl)C₀-C₂alkyl, (phenyl)C₁-C₂alkoxy, phenoxy, and 5- or 6-membered heteroaryl containing 1, 2, or 3 heteroatoms independently chosen from N, O, B, and S, each of which (z) is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, —OSi(CH₃)₂C(CH₃)₃, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; J is independently chosen at each occurrence from a covalent bond, C₁-C₄alkylene, —OC₁-C₄alkylene, C₂-C₄alkenylene, and C₂-C₄alkynylene; R²¹ and R²² are independently chosen at each occurrence from hydrogen, hydroxyl, cyano, amino, C₁-C₆alkyl, C₁-C₆haloalkyl, C₁-C₆alkoxy, (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, —C₁-C₄alkylOC(O)OC₁-C₆alkyl, —C₁-C₄alkylOC(O)C₁-C₆alkyl, —C₁-C₄alkylC(O)OC₁-C₆alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S; R²³ is independently chosen at each occurrence from (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S; R²⁴ and R²⁵ are taken together with the nitrogen to which they are attached to form a 4- to 7-membered monocyclic heterocycloalkyl group, or a 6- to 10-membered bicyclic heterocyclic group having fused, spiro, or bridged rings; each of which (s) may be unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂, —P(O)(OH)₂, C₁-C₆alkyl, C₁-C₆alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₆alkylester, C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; and wherein X² is nitrogen or at least one of (d), (e), (g), (i), (l), (n), (p), (s), (v), (x), or (y) is present.
 2. A compound of the formula

or a pharmaceutically acceptable salt thereof, wherein Q¹ is N(R¹) or C(R¹R^(1′)); Q² is C(R²R^(2′)), C(R²R^(2′))—C(R²R^(2′)), S, O, N(R²) or C(R²R^(2′))O; Q³ is N(R³), S, or C(R³R^(3′)); X¹ and X² are independently N, CH, or CZ, or X¹ and X² together are C═C; Z is F, Cl, NH₂, CH₃, CH₂D, CHD₂, or CD₃; or

is selected from

R¹, R^(1′), R², R^(2′), R³, and R^(3′) are independently chosen from hydrogen, halogen, hydroxyl, nitro, cyano, amino, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkynyl, C₁-C₆alkoxy, C₂-C₆alkynyl, C₂-C₆alkanoyl, C₁-C₆thioalkyl, hydroxyC₁-C₆alkyl, aminoC₁-C₆alkyl, —C₀-C₄alkylNR⁹R¹⁰, —C(O)OR⁹, —OC(O)R⁹, —NR⁹C(O)R¹⁰, —C(O)NR⁹R¹⁰, —OC(O)NR⁹R¹⁰, —NR⁹C(O)OR¹⁰, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R⁹ and R¹⁰ are independently chosen from hydrogen, C₁-C₆alkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), and —O—C₀-C₄alkyl(C₃-C₇cycloalkyl); or R¹ and R² are linked to form a 3- to 6-membered carbocyclic or aryl ring; or R² and R³ are linked to form a 3- to 6-membered carbocyclic ring; or R¹ and R^(1′), or R² and R^(2′), or R³ and R^(3′) are linked to form a 3- to 6-membered carbocyclic spiro ring; or R¹ and R^(1′), R² and R^(2′) or R³ and R^(3′) are linked to form a 3- to 6-membered heterocyclic spiro ring; each of which ring is unsubstituted or substituted with 1 or more substituents independently chosen from halogen, hydroxyl, cyano, —COOH, C₁-C₄alkyl, C₂-C₄alkenyl, C₂-C₄alkynyl, C₁-C₄alkoxy, C₂-C₄alkanoyl, hydroxyC₁-C₄alkyl, (mono- and di-C₁-C₄alkylamino)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —O—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; or R¹ and R^(1′) or R² and R^(2′) are linked to form a carbonyl group; or R¹ and R² or R² and R³ can be taken together to form a carbon-carbon double bond; R and R′ are independently selected from H, alkyl, cycloalkyl, cycloalkylalkyl, heterocycle, heterocycloalkyl, aryl, arylalkyl, heteroaryl, and heteroarylalkyl; A is a group chosen from (k) and (l) where (k) is

 and (l) is

X⁴ is B(OH) and Y is CHR⁹; or X⁴ is CHR⁹ and Y is B(OH); R¹⁰¹ is hydrogen, alkyl, carboxy; R⁴ is (m) or (n) (m) —CHO, —CONH₂, or C₂-C₆alkanoyl, including C(O)C₃-C₇cycloalkyl; (n) hydrogen, —SO₂NH₂, —C(CH₂)F, —CH(CF₃)NH₂, C₁-C₆alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C(O)C₀-C₂alkyl(C₃-C₇cycloalkyl),

each of which R⁴ other than hydrogen, —CHO, and —CONH₂, is unsubstituted or substituted with one or more of amino, imino, halogen, hydroxyl, cyano, cyanoimino, C₁-C₂alkyl, C₁-C₂alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R⁵ and R⁶ are independently chosen from (o) and (p) (o) —CHO, —C(O)NH₂, —C(O)NH(CH₃), or C₂-C₆alkanoyl; (p) hydrogen, hydroxyl, halogen, cyano, nitro, —COOH, —SO₂NH₂, —C(NH₂)C₁-C₃alkyl, —C(NH₂)C₁-C₃haloalkyl, —CF(C═CH₂), —C(═NCN)C₁-C₆alkyl, C₁-C₆alkyl, C₂-C₆alkenyl, C₁-C₆alkoxy, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C(O)C₀-C₄alkyl(C₃-C₇cycloalkyl), —P(O)(OR⁹)₂, —OC(O)R⁹, —C(O)OR⁹, —C(O)N(CH₂CH₂R⁹)(R¹⁰), —NR⁹C(O)R¹⁰, phenyl, or 5- to 6-membered heteroaryl. each R⁵ and R⁶ other than hydrogen, hydroxyl, cyano, and —COOH is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, amino, imino, cyano, cyanoimino, C₁-C₂alkyl, C₁-C₄alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₂haloalkyl, C₁-C₂haloalkoxy, C(O)alkyl, C(O)cycloalkyl, C(O)aryl, C(O)heterocycle, and C(O)heteroaryl. R^(6′) is hydrogen, halogen, hydroxyl, C₁-C₄alkyl, or C₁-C₄alkoxy; or R⁶ and R^(6′) may be taken together to form an oxo, vinyl, or imino group; R⁷ is hydrogen, C₁-C₆alkyl, or —C₀-C₄alkyl(C₃-C₇cycloalkyl); R⁸ and R^(8′) are independently chosen from hydrogen, halogen, hydroxyl, C₁-C₆alkyl, C₁-C₆alkoxy, and (C₁-C₄alkylamino)C₀-C₂alkyl, or R⁸ and R^(8′) are taken together to form an oxo group; R¹⁶ is 0 or 1 or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R¹⁹ is hydrogen, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, —SO₂C₁-C₆alkyl, (mono- and di-C₁-C₆alkylamino)C₁-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), each of which R¹⁹ other than hydrogen is substituted with 0 or 1 or more substituents independently chosen from halogen, hydroxyl, amino, —COOH, and —C(O)OC₁-C₄alkyl; X¹¹ is N or CR¹¹; X¹² is N or CR¹²; X¹³ is N or CR¹³; X¹⁴ is N or CR¹⁴; where no more than 2 of X¹¹, X¹², X¹³, and X¹⁴ are N; R¹¹, R¹⁴, and R¹⁵ are independently chosen at each occurrence from hydrogen, halogen, hydroxyl, nitro, cyano, —NR⁹C(O)R¹⁰, C(O)NR⁹R¹⁰, —O(PO)(OR⁹)₂, —(PO)(OR⁹)₂, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkenyl(aryl), C₂-C₆alkenyl(cycloalkyl), C₂-C₆alkenyl(heterocycle), C₂-C₆alkenyl(heteroaryl), C₂-C₆alkynyl, C₂-C₆alkynyl(aryl), C₂-C₆alkynyl(cycloalkyl), C₂-C₆alkynyl(heterocycle), C₂-C₆alkynyl(heteroaryl), C₂-C₆alkanoyl, C₁-C₆alkoxy, C₁-C₆thioalkyl, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl), (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S), —C₀-C₄alkoxy(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R¹² and R¹³ are independently chosen from (q), (r), and (s), (q) hydrogen, halogen, hydroxyl, nitro, cyano, amino, —COOH, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, (r) C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, C₂-C₆alkenyloxy, —C(O)OR⁹, C₁-C₆thioalkyl, —C₀-C₄alkylNR⁹R¹⁰, —C(O)NR⁹R¹⁰, —SO₂R⁹, —SO₂NR⁹R¹⁰, —OC(O)R⁹, and —C(NR⁹)NR⁹R¹⁰, each of which (r) is unsubstituted or substituted with one or more substituents independently selected from halogen, hydroxyl, nitro, cyano, amino, —COOH, —CONH₂C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, and each of which (r) is also optionally substituted with one substituent chosen from phenyl and 4- to 7-membered heterocycle containing 1, 2, or 3 heteroatoms independently chosen from N, O, and S; which phenyl or 4- to 7-membered heterocycle is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl)(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; (s) —C(CH₂)₂R³⁰; R³⁰ is —NR⁹C(O)R³¹ or R³²; R³¹ and R³² are C₁-C₆alkyl, C₁-C₆haloalkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S; L is either (t), (u), or (v) where (t) is a group of the formula

R¹⁷ is hydrogen or C₁-C₆alkyl and R¹⁸ and R^(18′) are independently chosen from hydrogen, halogen, and methyl; and m is 0, 1, 2, or 3; and (u) is a bond, (v) or a directly linked optionally substituted alkyl, alkyl(heteroaryl), heterocyclic aryl, heteroaryl, moiety including but not limited to:

B is a monocyclic or bicyclic carbocyclic or carbocyclic-oxy group or a monocyclic, bicyclic, or tricyclic heterocyclic group having 1, 2, 3, or 4 heteroatoms independently selected from N, O, and S and from 4 to 7 ring atoms per ring, or B is a C₂-C₆alkenyl or C₂-C₆alkynyl group; each of which B is unsubstituted or substituted with one or more substituents independently chosen from (w) and (x) and 0 or 1 substituents chosen from (y) and (z) (w) halogen, hydroxyl, —COOH, cyano, C₁-C₆alkyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkylNR⁹R¹⁰, —SO₂R⁹, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; (x) nitro, C₂-C₆alkenyl, C₂-C₆alkynyl, C₁-C₆thioalkyl, -JC₃-C₇cycloalkyl, —B(OH)₂, -JC(O)NR⁹R²³, -JOSO₂OR²¹, SR⁹, —C(O)(CH₂)₁₋₄S(O)R²¹, —O(CH₂)₁₋₄S(O)NR²¹R²², -JOP(O)(OR²¹)(OR²²), -JP(O)(OR²¹)(OR²²), -JOP(O)(OR²¹)R²², -JP(O)(OR²¹)R²², -JOP(O)R²¹R²², -JP(O)R²¹R²², -JSP(O)(OR²¹)(OR²²), -JSP(O)(OR²¹)(R²²), -JSP(O)(R²¹)(R²²), -JNR⁹P(O)(NHR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(OR²²), -JC(S)R²¹, -JNR²¹SO₂R²², -JNR⁹S(O)_(n)NR¹⁰R²², -JSO₂NR⁹COR²², -JSO₂NR⁹CONR²¹R²², -JNR²¹SO₂R²², -JC(O)NR²¹SO₂R²², -JC(NH₂)NR²², -JC(NH₂)NS(O)₂R²², -JOC(O)NR²¹R²², -JNR²¹C(O)OR²², -JNR²¹OC(O)R²², —(CH₂)₁₋₄C(O)NR²¹R²², -JC(O)R²⁴R²⁵, -JNR⁹C(O)R²¹, -JC(O)R²¹, -JNR⁹C(O)NR¹R²², —CCR²¹, —(CH₂)₁₋₄OC(O)R²¹, and -JC(O)OR²³; each of which (x) may be unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂, —P(O)(OH)₂, C₁-C₆alkyl, C₁-C₆alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₆alkylester, C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; (y) naphthyl, naphthyloxy, indanyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl containing 1 or 2 heteroatoms chosen from N, O, and S, and bicyclic heterocycle containing 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and containing 4- to 7-ring atoms in each ring; each of which (y) is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; and (z) tetrazolyl, (phenyl)C₀-C₂alkyl, (phenyl)C₁-C₂alkoxy, phenoxy, and 5- or 6-membered heteroaryl containing 1, 2, or 3 heteroatoms independently chosen from N, O, B, and S, each of which (z) is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, —OSi(CH₃)₂C(CH₃)₃, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; J is independently chosen at each occurrence from a covalent bond, C₁-C₄alkylene, —OC₁-C₄alkylene, C₂-C₄alkenylene, and C₂-C₄alkynylene; R²¹ and R²² are independently chosen at each occurrence from hydrogen, hydroxyl, cyano, amino, C₁-C₆alkyl, C₁-C₆haloalkyl, C₁-C₆alkoxy, (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, —C₁-C₄alkylOC(O)OC₁-C₆alkyl, —C₁-C₄alkylOC(O)C₁-C₆alkyl, —C₁-C₄alkylC(O)OC₁-C₆alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S; R²³ is independently chosen at each occurrence from (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S; R²⁴ and R²⁵ are taken together with the nitrogen to which they are attached to form a 4- to 7-membered monocyclic heterocycloalkyl group, or a 6- to 10-membered bicyclic heterocyclic group having fused, spiro, or bridged rings; each of which (s) may be unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂, —P(O)(OH)₂, C₁-C₆alkyl, C₁-C₆alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₆alkylester, C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; and or at least one of (l), (n), (p), (s), (v), (x), or (y) is present.
 3. The compound of claim 2, wherein the

ring is selected from:


4. The compound of claim 2, wherein the

ring is selected from:


5. The compound of claim 2, wherein the

ring is selected from:


6. The compound of claim 2, wherein: a) R¹ and R^(1′), or R² and R^(2′), or R³ and R^(3′) are linked to form a 3- to 6-membered carbocyclic spiro ring; or b) R¹ and R^(1′), R² and R^(2′) or R³ and R^(3′) are linked to form a 3- to 6-membered heterocyclic spiro ring; or c) R¹ and R² are linked to form a 3- to 6-membered carbocyclic or aryl ring; or d) R² and R³ are linked to form a 3- to 6-membered carbocyclic ring.
 7. The compound of claim 2, wherein the R¹³ moiety has at least one substituent.
 8. The compound of claim 2, wherein R¹³ is —C(CH₂)₂R³⁰ wherein: R³⁰ is optionally substituted —NR⁹C(O)R³¹ or R³².
 9. The compound of claim 8, wherein R¹³ is C₁-C₆alkyl, C₁-C₆haloalkyl, C₂-C₆alkenyl, C₂-C₆alkynyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl, (aryl)C₀-C₄alkyl, (heterocycle)C₀-C₄alkyl and (heteroaryl)C₀-C₄alkyl wherein each group can be optionally substituted with one or more substituents independently chosen from hydroxyl, nitro, cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂, —P(O)(OH)₂, C₁-C₆alkyl, C₁-C₆alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₆alkylester, C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy.
 10. The compound of claim 2, wherein B is selected from a monocyclic carbocyclic or bicyclic carbocyclic moiety which is unsubstituted or substituted with one or more substituents independently chosen from R³³ and R³⁴, and 0 or 1 substituents chosen from R³⁵ and R³⁶.
 11. The compound of claim 10 wherein the monocyclic carbocyclic moiety is selected from cyclohexenyl, cyclohexyl, cyclopentenyl, cyclopentyl, cyclobutenyl, cyclobutyl or cyclopropyl optionally substituted with halogen, cyano, hydroxyl, C₁-C₆alkyl, C₂-C₆alkanoyl, C₁-C₆alkoxy or phenyl.
 12. The compound of claim 2, wherein B is selected from a monocyclic, bicyclic, or tricyclic heterocyclic group having 1, 2, 3, or 4 heteroatoms independently selected from N, O, and S and from 4 to 7 ring atoms per ring; wherein B is unsubstituted or substituted with one or more substituents independently chosen from R³³ and R³⁴, and 0 or 1 substituents chosen from R³⁵ and R³⁶.
 13. The compound of claim 12, wherein the monocyclic, bicyclic, or tricyclic heterocyclic group having 1, 2, 3, or 4 heteroatoms independently selected from N, O, and S and from 4 to 7 ring atoms per ring is selected from pyrrolidinyl, dihydrofuranyl, tetrahydrothienyl, tetrahydropyranyl, dihydropyranyl, tetrahydrothiopyranyl, piperidino, piperidonyl, morpholino, thiomorpholino, thioxanyl or piperazinyl optionally substituted with halogen, cyano, hydroxyl, C₁-C₆alkyl, C₂-C₆alkanoyl, C₁-C₆alkoxy or phenyl.
 14. The compound of claim 2, wherein B is selected from —(C₀-C₄alkyl)(aryl); —(C₀-C₄alkyl)(heteroaryl); or —(C₀-C₄alkyl)(biphenyl) wherein B is unsubstituted or substituted with one or more substituents independently chosen from R³³ and R³⁴, and 0 or 1 substituents chosen from R³⁵ and R³⁶.
 15. The compound of claim 14, wherein the —(C₀-C₄alkyl)(aryl) group is phenyl or benzyl optionally substituted with halogen, hydroxyl, —COOH, cyano, C₁-C₆alkyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkylNR⁹R¹⁰, —SO₂R⁹, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, C₂-C₆alkenyl, C₂-C₆alkynyl, C₁-C₆thioalkyl, or -JC₃-C₇cycloalkyl.
 16. The compound of claim 14, wherein the —(C₀-C₄alkyl)(heteroaryl) group is imidazolyl, imidazopyridinyl, pyrimidinyl, pyrazolyl, triazolyl, pyrazinyl, tetrazolyl, furyl, thienyl, isoxazolyl, thiazolyl, oxadiazolyl, oxazolyl, isothiazolyl or pyrrolyl optionally substituted with halogen, hydroxyl, —COOH, cyano, C₁-C₆alkyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkylNR⁹R¹⁰, —SO₂R⁹, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, C₂-C₆alkenyl, C₂-C₆alkynyl, C₁-C₆thioalkyl, or -JC₃-C₇cycloalkyl.
 17. The compound of claim 14, wherein the —(C₀-C₄alkyl)(biphenyl) group is biphenyl optionally substituted with halogen, hydroxyl, —COOH, cyano, C₁-C₆alkyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkylNR⁹R¹⁰, —SO₂R⁹, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, C₂-C₆alkenyl, C₂-C₆alkynyl, C₁-C₆thioalkyl, or -JC₃-C₇cycloalkyl.
 18. The compound of claim 1, wherein the compound is selected from:


19. A method for the treatment of a disorder mediated by the complement pathway, comprising administering an effective amount to a host in need thereof of a compound of the formula

or a pharmaceutically acceptable salt thereof, wherein Q¹ is N(R¹) or C(R¹R^(1′)); Q² is Q² is C(R²R^(2′)), C(R²R^(2′))—C(R²R^(2′)), S, O, N(R²) or C(R²R^(2′))O; Q³ is N(R³), S, or C(R³R^(3′)); (b) X¹ and X² are independently N or CH, or (b) X¹ and X² together are C═C; R¹, R^(1′), R², R^(2′), R³, and R^(3′) are independently chosen at each occurrence from (c) and (d) (c) hydrogen, halogen, hydroxyl, nitro, cyano, amino, C₁-C₆alkyl, C₂-C₆alkenyl, C₁-C₆alkoxy, C₂-C₆alkynyl, C₂-C₆alkanoyl, C₁-C₆thioalkyl, hydroxyC₁-C₆alkyl, aminoC₁-C₆alkyl, —C₀-C₄alkylNR⁹R¹⁰, —C(O)OR⁹, —OC(O)R⁹, —NR⁹C(O)R¹⁰, —C(O)NR⁹R¹⁰, —OC(O)NR⁹R¹⁰, —O(heteroaryl), —NR⁹C(O)OR¹⁰, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, R⁹ and R¹⁰ are independently chosen at each occurrence from hydrogen, C₁-C₆alkyl, and (C₃-C₇cycloalkyl)C₀-C₄alkyl; (d) —C₀-C₄alkyl(C₃-C₇cycloalkyl) and —O—C₀-C₄alkyl(C₃-C₇cycloalkyl); Additionally any one of the following rings (e), (f), (g), (h), (i), or (j) may be present: (e) R¹ and R^(1′) or R³ and R^(3′) may be taken together to form a 3- to 6-membered carbocyclic spiro ring or a 3- to 6-membered heterocyclic spiro ring containing 1 or 2 heteroatoms independently chosen from N, O, or S; (f) R² and R^(2′) may be taken together to form a 3- to 6-membered carbocyclic spiro ring, (g) R² and R^(2′) may be taken together to form a 3- to 6-membered heterocyclic spiro ring, each of which spiro rings (e), (f), and (g) is unsubstituted or substituted with one or more halogen or methyl substituents; (h) R¹ and R² may be taken together to form a 3-membered carbocyclic ring; or R¹ and R^(1′) or R² and R^(2′) are linked to form a carbonyl group; or R¹ and R² or R² and R³ can be taken together to form a carbon-carbon double bond; (i) R¹ and R² may be taken together to form a 4- to 6-membered carbocyclic ring or a 4- to 6-membered heterocyclic ring containing 1 or 2 heteroatoms independently chosen from N, O, and S; (j) R² and R³, if bound to adjacent carbon atoms, may be taken together to form a 3- to 6-membered carbocyclic ring or a 3- to 6-membered heterocyclic ring; each of which ring (h), (i), and (j) may be unsubstituted or substituted with 1 or more substituents independently chosen from halogen, hydroxyl, cyano, —COOH, C₁-C₄alkyl, C₂-C₄alkenyl, C₁-C₄alkoxy, C₂-C₄alkanoyl, hydroxyC₁-C₄alkyl, (mono- and di-C₁-C₄alkylamino)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —O—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; A is a group chosen from (k) and (l) where (k) is

 and (l) is

X⁴ is B(OH) and Y is CHR⁹; or X⁴ is CHR⁹ and Y is B(OH); R¹⁰¹ is hydrogen, alkyl, carboxy; R⁴ is (m) or (n) (m) —CHO, —CONH₂, or C₂-C₆alkanoyl, including C(O)C₃-C₇cycloalkyl; (n) hydrogen, —SO₂NH₂, —C(CH₂)F, —CH(CF₃)NH₂, C₁-C₆alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C(O)C₀-C₂alkyl(C₃-C₇cycloalkyl),

each of which R⁴ other than hydrogen, —CHO, and —CONH₂, is unsubstituted or substituted with one or more of amino, imino, halogen, hydroxyl, cyano, cyanoimino, C₁-C₂alkyl, C₁-C₂alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R⁵ and R⁶ are independently chosen from (o) and (p) (o) —CHO, —C(O)NH₂, —C(O)NH(CH₃), or C₂-C₆alkanoyl; (p) hydrogen, hydroxyl, halogen, cyano, nitro, —COOH, —SO₂NH₂, —C(NH₂)C₁-C₃alkyl, —C(NH₂)C₁-C₃haloalkyl, —CF(C═CH₂), —C(═NCN)C₁-C₆alkyl, C₁-C₆alkyl, C₂-C₆alkenyl, C₁-C₆alkoxy, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C(O)C₀-C₄alkyl(C₃-C₇cycloalkyl), —P(O)(OR⁹)₂, —OC(O)R⁹, —C(O)OR⁹, —C(O)N(CH₂CH₂R⁹)(R¹⁰), —NR⁹C(O)R¹⁰, phenyl, or 5- to 6-membered heteroaryl. each R⁵ and R⁶ other than hydrogen, hydroxyl, cyano, and —COOH is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, amino, imino, cyano, cyanoimino, C₁-C₂alkyl, C₁-C₄alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₂haloalkyl, C₁-C₂haloalkoxy, C(O)alkyl, C(O)cycloalkyl, C(O)aryl, C(O)heterocycle, and C(O)heteroaryl. R^(6′) is hydrogen, halogen, hydroxyl, C₁-C₄alkyl, or C₁-C₄alkoxy; or R⁶ and R^(6′) may be taken together to form an oxo, vinyl, or imino group; R⁷ is hydrogen, C₁-C₆alkyl, or —C₀-C₄alkyl(C₃-C₇cycloalkyl); R⁸ and R^(8′) are independently chosen from hydrogen, halogen, hydroxyl, C₁-C₆alkyl, C₁-C₆alkoxy, and (C₁-C₄alkylamino)C₀-C₂alkyl, or R⁸ and R^(8′) are taken together to form an oxo group; R¹⁶ is 0 or 1 or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R¹⁹ is hydrogen, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, —SO₂C₁-C₆alkyl, (mono- and di-C₁-C₆alkylamino)C₁-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), each of which R¹⁹ other than hydrogen is substituted with 0 or 1 or more substituents independently chosen from halogen, hydroxyl, amino, —COOH, and —C(O)OC₁-C₄alkyl; X¹¹ is N or CR¹¹; X¹² is N or CR¹²; X¹³ is N or CR¹³; X¹⁴ is N or CR¹⁴; where no more than 2 of X¹¹, X¹², X¹³, and X¹⁴ are N; R¹¹, R¹⁴, and R¹⁵ are independently chosen at each occurrence from hydrogen, halogen, hydroxyl, nitro, cyano, —NR⁹C(O)R¹⁰, C(O)NR⁹R¹⁰, —O(PO)(OR⁹)₂, —(PO)(OR⁹)₂, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkenyl(aryl), C₂-C₆alkenyl(cycloalkyl), C₂-C₆alkenyl(heterocycle), C₂-C₆alkenyl(heteroaryl), C₂-C₆alkynyl, C₂-C₆alkynyl(aryl), C₂-C₆alkynyl(cycloalkyl), C₂-C₆alkynyl(heterocycle), C₂-C₆alkynyl(heteroaryl), C₂-C₆alkanoyl, C₁-C₆alkoxy, C₁-C₆thioalkyl, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl), (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S), —C₀-C₄alkoxy(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R¹² and R¹³ are independently chosen from (q), (r), and (s), (q) hydrogen, halogen, hydroxyl, nitro, cyano, amino, —COOH, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, (r) C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, C₂-C₆alkenyloxy, —C(O)OR⁹, C₁-C₆thioalkyl, —C₀-C₄alkylNR⁹R¹⁰, —C(O)NR⁹R¹⁰, —SO₂R⁹, —SO₂NR⁹R¹⁰, —OC(O)R⁹, and —C(NR⁹)NR⁹R¹⁰, each of which (r) is unsubstituted or substituted with one or more substituents independently selected from halogen, hydroxyl, nitro, cyano, amino, —COOH, —CONH₂C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, and each of which (r) is also optionally substituted with one substituent chosen from phenyl and 4- to 7-membered heterocycle containing 1, 2, or 3 heteroatoms independently chosen from N, O, and S; which phenyl or 4- to 7-membered heterocycle is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl)(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; (s) —C(CH₂)₂R³⁰; R³⁰ is —NR⁹C(O)R³¹ or R³²; R³¹ and R³² are C₁-C₆alkyl, C₁-C₆haloalkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S; L is either (t), (u), or (v) where (t) is a group of the formula

R¹⁷ is hydrogen or C₁-C₆alkyl and R¹⁸ and R^(18′) are independently chosen from hydrogen, halogen, and methyl; and m is 0, 1, 2, or 3; and (u) is a bond, (v) or a directly linked optionally substituted alkyl, alkyl(heteroaryl), heterocyclic aryl, heteroaryl, moiety including but not limited to:

B is a monocyclic or bicyclic carbocyclic or carbocyclic-oxy group or a monocyclic, bicyclic, or tricyclic heterocyclic group having 1, 2, 3, or 4 heteroatoms independently selected from N, O, and S and from 4 to 7 ring atoms per ring, or B is a C₂-C₆alkenyl or C₂-C₆alkynyl group; each of which B is unsubstituted or substituted with one or more substituents independently chosen from (w) and (x) and 0 or 1 substituents chosen from (y) and (z) (w) halogen, hydroxyl, —COOH, cyano, C₁-C₆alkyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkylNR⁹R¹⁰, —SO₂R⁹, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; (x) nitro, C₂-C₆alkenyl, C₂-C₆alkynyl, C₁-C₆thioalkyl, -JC₃-C₇cycloalkyl, —B(OH)₂, -JC(O)NR⁹R²³, -JOSO₂OR²¹, SR⁹, —C(O)(CH₂)₁₋₄S(O)R²¹, —O(CH₂)₁₋₄S(O)NR²¹R²², -JOP(O)(OR²¹)(OR²²), -JP(O)(OR²¹)(OR²²), -JOP(O)(OR²¹)R²², -JP(O)(OR²¹)R²², -JOP(O)R²¹R²², -JP(O)R²¹R²², -JSP(O)(OR²¹)(OR²²), -JSP(O)(OR²¹)(R²²), -JSP(O)(R²¹)(R²²), -JNR⁹P(O)(NHR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(OR²²), -JC(S)R²¹, -JNR²¹SO₂R²², -JNR⁹S(O)_(n)NR¹⁰R²², -JSO₂NR⁹COR²², -JSO₂NR⁹CONR²¹R²², -JNR²¹SO₂R²², -JC(O)NR²¹SO₂R²², -JC(NH₂)NR²², -JC(NH₂)NS(O)₂R²², -JOC(O)NR²¹R²², -JNR²¹C(O)OR²², -JNR²¹OC(O)R²², —(CH₂)₁₋₄C(O)NR²¹R²², -JC(O)R²⁴R²⁵, -JNR⁹C(O)R²¹, -JC(O)R²¹, -JNR⁹C(O)NR¹R²², —CCR²¹, —(CH₂)₁₋₄OC(O)R²¹, and -JC(O)OR²³; each of which (x) may be unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂, —P(O)(OH)₂, C₁-C₆alkyl, C₁-C₆alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₆alkylester, C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; (y) naphthyl, naphthyloxy, indanyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl containing 1 or 2 heteroatoms chosen from N, O, and S, and bicyclic heterocycle containing 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and containing 4- to 7-ring atoms in each ring; each of which (y) is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; and (z) tetrazolyl, (phenyl)C₀-C₂alkyl, (phenyl)C₁-C₂alkoxy, phenoxy, and 5- or 6-membered heteroaryl containing 1, 2, or 3 heteroatoms independently chosen from N, O, B, and S, each of which (z) is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, —OSi(CH₃)₂C(CH₃)₃, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; J is independently chosen at each occurrence from a covalent bond, C₁-C₄alkylene, —OC₁-C₄alkylene, C₂-C₄alkenylene, and C₂-C₄alkynylene; R²¹ and R²² are independently chosen at each occurrence from hydrogen, hydroxyl, cyano, amino, C₁-C₆alkyl, C₁-C₆haloalkyl, C₁-C₆alkoxy, (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, —C₁-C₄alkylOC(O)OC₁-C₆alkyl, —C₁-C₄alkylOC(O)C₁-C₆alkyl, —C₁-C₄alkylC(O)OC₁-C₆alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S; R²³ is independently chosen at each occurrence from (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S; R²⁴ and R²⁵ are taken together with the nitrogen to which they are attached to form a 4- to 7-membered monocyclic heterocycloalkyl group, or a 6- to 10-membered bicyclic heterocyclic group having fused, spiro, or bridged rings; each of which (s) may be unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂, —P(O)(OH)₂, C₁-C₆alkyl, C₁-C₆alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₆alkylester, C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; and wherein X² is nitrogen or at least one of (d), (e), (g), (i), (l), (n), (p), (s), (v), (x), or (y) is present.
 20. The method of claim 19, wherein the disorder is age-related macular degeneration (AMD).
 21. The method of claim 19, wherein the disorder is retinal degeneration, ophthalmic disease, multiple sclerosis, arthritis, or COPD.
 22. The method of claim 19, wherein the disorder is an ophthalmic disease.
 23. The method of claim 19, wherein the disorder is paroxysymal nocturnal hemoglobinuria (PNH).
 24. The method of claim 19, wherein the disorder is a respiratory disease.
 25. The method of claim 19, wherein the disorder is a cardiovascular disease.
 26. The method of claim 19, wherein the disorder is atypical or typical hemolytic uremic syndrome.
 27. The method of claim 19, wherein the disorder is rheumatoid arthritis.
 28. The method of claim 19, wherein the disorder is C3 glomerulonephritis.
 29. The method of claim 19, wherein the host is a human.
 30. The method of claim 22, wherein the compound is delivered intravitreal, subchoroidal, or suprachoroidal.
 31. The method of claim 19, wherein the compound is administered in combination with an effective amount of an additional active agent.
 32. A method for the treatment of a disorder mediated by the complement pathway, comprising administering an effective amount to a host in need thereof of a compound formula

or a pharmaceutically acceptable salt thereof, wherein Q¹ is N(R¹) or C(R¹R^(1′)); Q² is C(R²R^(2′)), C(R²R^(2′))—C(R²R^(2′)), S, O, N(R²) or C(R²R^(2′))O; Q³ is N(R³), S, or C(R³R^(3′)); X¹ and X² are independently N, CH, or CZ, or X¹ and X² together are C═C; Z is F, Cl, NH₂, CH₃, CH₂D, CHD₂, or CD₃; or

is selected from

R¹, R^(1′), R², R^(2′), R³, and R^(3′) are independently chosen from hydrogen, halogen, hydroxyl, nitro, cyano, amino, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkynyl, C₁-C₆alkoxy, C₂-C₆alkynyl, C₂-C₆alkanoyl, C₁-C₆thioalkyl, hydroxyC₁-C₆alkyl, aminoC₁-C₆alkyl, —C₀-C₄alkylNR⁹R¹⁰, —C(O)OR⁹, —OC(O)R⁹, —NR⁹C(O)R¹⁰, —C(O)NR⁹R¹⁰, —OC(O)NR⁹R¹⁰, —NR⁹C(O)OR¹⁰, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R⁹ and R¹⁰ are independently chosen from hydrogen, C₁-C₆alkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), and —O—C₀-C₄alkyl(C₃-C₇cycloalkyl); or R¹ and R² are linked to form a 3- to 6-membered carbocyclic or aryl ring; or R² and R³ are linked to form a 3- to 6-membered carbocyclic ring; or R¹ and R^(1′), or R² and R^(2′), or R³ and R^(3′) are linked to form a 3- to 6-membered carbocyclic spiro ring; or R¹ and R^(1′), R² and R^(2′) or R³ and R^(3′) are linked to form a 3- to 6-membered heterocyclic spiro ring; each of which ring is unsubstituted or substituted with 1 or more substituents independently chosen from halogen, hydroxyl, cyano, —COOH, C₁-C₄alkyl, C₂-C₄alkenyl, C₂-C₄alkynyl, C₁-C₄alkoxy, C₂-C₄alkanoyl, hydroxyC₁-C₄alkyl, (mono- and di-C₁-C₄alkylamino)C₀-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —O—C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; or R¹ and R^(1′) or R² and R^(2′) are linked to form a carbonyl group; or R¹ and R² or R² and R³ can be taken together to form a carbon-carbon double bond; R and R′ are independently selected from H, alkyl, cycloalkyl, cycloalkylalkyl, heterocycle, heterocycloalkyl, aryl, arylalkyl, heteroaryl, and heteroarylalkyl; A is a group chosen from (k) and (l) where (k) is

 and (l) is

X⁴ is B(OH) and Y is CHR⁹; or X⁴ is CHR⁹ and Y is B(OH); R¹⁰¹ is hydrogen, alkyl, carboxy; R⁴ is (m) or (n) (m) —CHO, —CONH₂, or C₂-C₆alkanoyl, including C(O)C₃-C₇cycloalkyl; (n) hydrogen, —SO₂NH₂, —C(CH₂)F, —CH(CF₃)NH₂, C₁-C₆alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C(O)C₀-C₂alkyl(C₃-C₇cycloalkyl),

each of which R⁴ other than hydrogen, —CHO, and —CONH₂, is unsubstituted or substituted with one or more of amino, imino, halogen, hydroxyl, cyano, cyanoimino, C₁-C₂alkyl, C₁-C₂alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R⁵ and R⁶ are independently chosen from (o) and (p) (o) —CHO, —C(O)NH₂, —C(O)NH(CH₃), or C₂-C₆alkanoyl; (p) hydrogen, hydroxyl, halogen, cyano, nitro, —COOH, —SO₂NH₂, —C(NH₂)C₁-C₃alkyl, —C(NH₂)C₁-C₃haloalkyl, —CF(C═CH₂), —C(═NCN)C₁-C₆alkyl, C₁-C₆alkyl, C₂-C₆alkenyl, C₁-C₆alkoxy, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —C(O)C₀-C₄alkyl(C₃-C₇cycloalkyl), —P(O)(OR⁹)₂, —OC(O)R⁹, —C(O)OR⁹, —C(O)N(CH₂CH₂R⁹)(R¹⁰), —NR⁹C(O)R¹⁰, phenyl, or 5- to 6-membered heteroaryl. each R⁵ and R⁶ other than hydrogen, hydroxyl, cyano, and —COOH is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, amino, imino, cyano, cyanoimino, C₁-C₂alkyl, C₁-C₄alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₂haloalkyl, C₁-C₂haloalkoxy, C(O)alkyl, C(O)cycloalkyl, C(O)aryl, C(O)heterocycle, and C(O)heteroaryl. R^(6′) is hydrogen, halogen, hydroxyl, C₁-C₄alkyl, or C₁-C₄alkoxy; or R⁶ and R^(6′) may be taken together to form an oxo, vinyl, or imino group; R⁷ is hydrogen, C₁-C₆alkyl, or —C₀-C₄alkyl(C₃-C₇cycloalkyl); R⁸ and R^(8′) are independently chosen from hydrogen, halogen, hydroxyl, C₁-C₆alkyl, C₁-C₆alkoxy, and (C₁-C₄alkylamino)C₀-C₂alkyl, or R⁸ and R^(8′) are taken together to form an oxo group; R¹⁶ is 0 or 1 or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R¹⁹ is hydrogen, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, —SO₂C₁-C₆alkyl, (mono- and di-C₁-C₆alkylamino)C₁-C₄alkyl, —C₀-C₄alkyl(C₃-C₇cycloalkyl), each of which R¹⁹ other than hydrogen is substituted with 0 or 1 or more substituents independently chosen from halogen, hydroxyl, amino, —COOH, and —C(O)OC₁-C₄alkyl; X¹¹ is N or CR¹¹; X¹² is N or CR¹²; X¹³ is N or CR¹³; X¹⁴ is N or CR¹⁴; where no more than 2 of X¹¹, X¹², X¹³, and X¹⁴ are N; R¹¹, R¹⁴, and R¹⁵ are independently chosen at each occurrence from hydrogen, halogen, hydroxyl, nitro, cyano, —NR⁹C(O)R¹⁰, C(O)NR⁹R¹⁰, —O(PO)(OR⁹)₂, —(PO)(OR⁹)₂, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkenyl(aryl), C₂-C₆alkenyl(cycloalkyl), C₂-C₆alkenyl(heterocycle), C₂-C₆alkenyl(heteroaryl), C₂-C₆alkynyl, C₂-C₆alkynyl(aryl), C₂-C₆alkynyl(cycloalkyl), C₂-C₆alkynyl(heterocycle), C₂-C₆alkynyl(heteroaryl), C₂-C₆alkanoyl, C₁-C₆alkoxy, C₁-C₆thioalkyl, —C₀-C₄alkyl(mono- and di-C₁-C₆alkylamino), —C₀-C₄alkyl(C₃-C₇cycloalkyl), (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S), —C₀-C₄alkoxy(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; R¹² and R¹³ are independently chosen from (q), (r), and (s), (q) hydrogen, halogen, hydroxyl, nitro, cyano, amino, —COOH, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, (r) C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, C₂-C₆alkenyloxy, —C(O)OR⁹, C₁-C₆thioalkyl, —C₀-C₄alkylNR⁹R¹⁰, —C(O)NR⁹R¹⁰, —SO₂R⁹, —SO₂NR⁹R¹⁰, —OC(O)R⁹, and —C(NR⁹)NR⁹R¹⁰, each of which (r) is unsubstituted or substituted with one or more substituents independently selected from halogen, hydroxyl, nitro, cyano, amino, —COOH, —CONH₂C₁-C₂haloalkyl, and C₁-C₂haloalkoxy, and each of which (r) is also optionally substituted with one substituent chosen from phenyl and 4- to 7-membered heterocycle containing 1, 2, or 3 heteroatoms independently chosen from N, O, and S; which phenyl or 4- to 7-membered heterocycle is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl)(C₃-C₇cycloalkyl), C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; (s) —C(CH₂)₂R³⁰; R³⁰ is —NR⁹C(O)R³¹ or R³²; R³¹ and R³² are C₁-C₆alkyl, C₁-C₆haloalkyl, (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S; L is either (t), (u), or (v) where (t) is a group of the formula

R¹⁷ is hydrogen or C₁-C₆alkyl and R¹⁸ and R^(18′) are independently chosen from hydrogen, halogen, and methyl; and m is 0, 1, 2, or 3; and (u) is a bond, (v) or a directly linked optionally substituted alkyl, alkyl(heteroaryl), heterocyclic aryl, heteroaryl, moiety including but not limited to:

B is a monocyclic or bicyclic carbocyclic or carbocyclic-oxy group or a monocyclic, bicyclic, or tricyclic heterocyclic group having 1, 2, 3, or 4 heteroatoms independently selected from N, O, and S and from 4 to 7 ring atoms per ring, or B is a C₂-C₆alkenyl or C₂-C₆alkynyl group; each of which B is unsubstituted or substituted with one or more substituents independently chosen from (w) and (x) and 0 or 1 substituents chosen from (y) and (z) (w) halogen, hydroxyl, —COOH, cyano, C₁-C₆alkyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, —C₀-C₄alkylNR⁹R¹⁰, —SO₂R⁹, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; (x) nitro, C₂-C₆alkenyl, C₂-C₆alkynyl, C₁-C₆thioalkyl, -JC₃-C₇cycloalkyl, —B(OH)₂, -JC(O)NR⁹R²³, -JOSO₂OR²¹, SR⁹, —C(O)(CH₂)₁₋₄S(O)R²¹, —O(CH₂)₁₋₄S(O)NR²¹R²², -JOP(O)(OR²¹)(OR²²), -JP(O)(OR²¹)(OR²²), -JOP(O)(OR²¹)R²², -JP(O)(OR²¹)R²², -JOP(O)R²¹R²², -JP(O)R²¹R²², -JSP(O)(OR²¹)(OR²²), -JSP(O)(OR²¹)(R²²), -JSP(O)(R²¹)(R²²), -JNR⁹P(O)(NHR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(NHR²²), -JNR⁹P(O)(OR²¹)(OR²²), -JC(S)R²¹, -JNR²¹SO₂R²², -JNR⁹S(O)_(n)NR¹⁰R²², -JSO₂NR⁹COR²², -JSO₂NR⁹CONR²¹R²², -JNR²¹SO₂R²², -JC(O)NR²¹SO₂R²², -JC(NH₂)NR²², -JC(NH₂)NS(O)₂R²², -JOC(O)NR²¹R²², -JNR²¹C(O)OR²², -JNR²¹OC(O)R²², —(CH₂)₁₋₄C(O)NR²¹R²², -JC(O)R²⁴R²⁵, -JNR⁹C(O)R²¹, -JC(O)R²¹, -JNR⁹C(O)NR¹R²², —CCR²¹, —(CH₂)₁₋₄OC(O)R²¹, and -JC(O)OR²³; each of which (x) may be unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂, —P(O)(OH)₂, C₁-C₆alkyl, C₁-C₆alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₆alkylester, C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; (y) naphthyl, naphthyloxy, indanyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl containing 1 or 2 heteroatoms chosen from N, O, and S, and bicyclic heterocycle containing 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and containing 4- to 7-ring atoms in each ring; each of which (y) is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; and (z) tetrazolyl, (phenyl)C₀-C₂alkyl, (phenyl)C₁-C₂alkoxy, phenoxy, and 5- or 6-membered heteroaryl containing 1, 2, or 3 heteroatoms independently chosen from N, O, B, and S, each of which (z) is unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, C₁-C₆alkyl, C₂-C₆alkenyl, C₂-C₆alkanoyl, C₁-C₆alkoxy, (mono- and di-C₁-C₆alkylamino)C₀-C₄alkyl, C₁-C₆alkylester, —C₀-C₄alkyl(C₃-C₇cycloalkyl), —SO₂R⁹, —OSi(CH₃)₂C(CH₃)₃, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; J is independently chosen at each occurrence from a covalent bond, C₁-C₄alkylene, —OC₁-C₄alkylene, C₂-C₄alkenylene, and C₂-C₄alkynylene; R²¹ and R²² are independently chosen at each occurrence from hydrogen, hydroxyl, cyano, amino, C₁-C₆alkyl, C₁-C₆haloalkyl, C₁-C₆alkoxy, (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, —C₁-C₄alkylOC(O)OC₁-C₆alkyl, —C₁-C₄alkylOC(O)C₁-C₆alkyl, —C₁-C₄alkylC(O)OC₁-C₆alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S; R²³ is independently chosen at each occurrence from (C₃-C₇cycloalkyl)C₀-C₄alkyl, (phenyl)C₀-C₄alkyl, (4- to 7-membered heterocycloalkyl)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S, and (5- or 6-membered unsaturated or aromatic heterocycle)C₀-C₄alkyl having 1, 2, or 3 heteroatoms independently chosen from N, O, and S; R²⁴ and R²⁵ are taken together with the nitrogen to which they are attached to form a 4- to 7-membered monocyclic heterocycloalkyl group, or a 6- to 10-membered bicyclic heterocyclic group having fused, spiro, or bridged rings; each of which (s) may be unsubstituted or substituted with one or more substituents independently chosen from halogen, hydroxyl, nitro, cyano, amino, oxo, —B(OH)₂, —Si(CH₃)₃, —COOH, —CONH₂, —P(O)(OH)₂, C₁-C₆alkyl, C₁-C₆alkoxy, —C₀-C₂alkyl(mono- and di-C₁-C₄alkylamino), C₁-C₆alkylester, C₁-C₄alkylamino, C₁-C₄hydroxylalkyl, C₁-C₂haloalkyl, and C₁-C₂haloalkoxy; and or at least one of (l), (n), (p), (s), (v), (x), or (y) is present.
 33. The method of claim 32, wherein the disorder is age-related macular degeneration (AMD).
 34. The method of claim 32, wherein the disorder is retinal degeneration, ophthalmic disease, multiple sclerosis, arthritis, or COPD.
 35. The method of claim 32, wherein the disorder is an ophthalmic disease.
 36. The method of claim 32, wherein the disorder is paroxysymal nocturnal hemoglobinuria (PNH).
 37. The method of claim 32, wherein the disorder is a respiratory disease.
 38. The method of claim 32, wherein the disorder is a cardiovascular disease.
 39. The method of claim 32, wherein the disorder is atypical or typical hemolytic uremic syndrome.
 40. The method of claim 32, wherein the disorder is rheumatoid arthritis.
 41. The method of claim 32, wherein the disorder is C3 glomerulonephritis.
 42. The method of claim 32, wherein the host is a human.
 43. The method of claim 35, wherein the compound is delivered intravitreal, subchoroidal, or suprachoroidal.
 44. The method of claim 32, wherein the compound is administered in combination with an effective amount of an additional active agent. 